NPI 1003476383

Keona Jewel Tillmon

Practitioner Other Technician Las Vegas, NV

Practice location

Address: 3920 W Charleston Blvd STE O, Las Vegas, NV 89102-1633
Phone: (702) 784-5541
Fax: (702) 915-7664

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X

Other Technician, Other providers in Nevada →

Registry record

NPI: 1003476383
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Jun 2019
Record last updated: 18 Jun 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.