Kenosha Tillman, NURSE PRACTITIONER
NPI 1275886103 · Psychiatric/Mental Health Nurse Practitioner · Fairburn, GA
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenosha Tillman, NURSE PRACTITIONER is a Psychiatric/Mental Health Nurse Practitioner provider in Fairburn, GA (NPI 1275886103).
Provider details
- NPI number
- 1275886103
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NURSE PRACTITIONER
- Sex
- Female
- Sole proprietor
- No
- License
- GAA-NP000960 (GA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 1255 Highway 54 WFayetteville, GA 30214-4526Phone: (478) 464-8134
- 101 Webb AvenueBruce, MS 38915-0701Phone: (662) 414-9212
Registry dates
- Enumerated
- 2012-10-16
- Last updated
- 2024-11-07
- Certified
- 2024-11-07
Frequently asked questions
- What is Kenosha Tillman's NPI number?
- Kenosha Tillman's National Provider Identifier (NPI) is 1275886103, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kenosha Tillman's specialty?
- Kenosha Tillman is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kenosha Tillman located?
- Kenosha Tillman's practice location on file with NPPES is 5220 Rosewood Pl, Fairburn, GA 30213-5113.
- What is Kenosha Tillman's phone number?
- The practice phone number listed in the NPPES registry for Kenosha Tillman is (901) 277-7086.
- Does Kenosha Tillman accept Medicare?
- Kenosha Tillman is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kenosha Tillman's NPI active?
- Yes — Kenosha Tillman's NPI (1275886103) is active in the NPPES registry as of the last update on 2024-11-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.