Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Stephanie Marie Tillery, CRNPFNP-C

Individual provider Nurse Practitioner · NPI 1316792997

Mrs. Stephanie Marie Tillery, CRNPFNP-C is a Nurse Practitioner in Philadelphia, Pennsylvania. Qualified in 2023, 3 years ago. Licensed in Pennsylvania.

Years since qualifying
3
Licensed in
PA
In the registry since
2024
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Practice location Address checks out

1010 W Lehigh Ave
Philadelphia, PA 19133-1640
Phone: (267) 273-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence SP029587 (PA)

Record details

NPI number1316792997
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNPFNP-C
Sole proprietorNo
NPI enumeratedApril 18, 2024
Last updated in NPPESAugust 11, 2025
Certification dateAugust 11, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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