Individual provider · Type 1 NPI

Stephanie Marie Tillery, CRNP FNP-C

Nurse Practitioner · Philadelphia, PA

NPI number 1316792997 Active

Practice location

1010 W Lehigh Ave
Philadelphia, PA 19133-1640

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XSP029587 (PA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1316792997

Stephanie Marie Tillery, CRNP FNP-C's National Provider Identifier is 1316792997, issued on Apr 18, 2024. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Philadelphia, PA. The record was last updated on Aug 11, 2025.