Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Ross Tillman, FNP

Individual provider Family Nurse Practitioner · NPI 1215543756

Justin Ross Tillman, FNP is a Nurse Practitioner in Gulfport, Mississippi. Qualified in 2020, 6 years ago. Practices with Singing River Health System, a 290-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
6
Licensed in
MS
In the registry since
2020
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

12330 Ashley Dr
Gulfport, MS 39503-2737
Phone: (228) 831-1572
Fax: (228) 831-1218
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 904708 (MS)

Record details

NPI number1215543756
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedSeptember 21, 2020
Last updated in NPPESOctober 13, 2021
Certification dateOctober 13, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Singing River Health System — 290 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Gulfport