Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Nicole Marie Tillman, MACCC-SLP

Individual provider Speech-Language Pathologist · NPI 1780065235

MS. Nicole Marie Tillman, MACCC-SLP is a Qualified Speech Language Pathologist in Cape Girardeau, Missouri. Qualified in 2006, 20 years ago. Practices with Powerback Rehabilitation LLC, a 616-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
20
Licensed in
MO
In the registry since
2015
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Practice location Address checks out

2001 N Kingshighway St
Cape Girardeau, MO 63701-2127
Phone: (573) 335-1999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 2009013299 (MO)

Record details

NPI number1780065235
Entity typeIndividual (Type 1)
GenderFemale
Credentials MACCC-SLP
Sole proprietorNo
NPI enumeratedJune 10, 2015
Last updated in NPPESOctober 18, 2021
Certification dateOctober 18, 2021

Medicare enrollment

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

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Powerback Rehabilitation Llc — 616 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Cape Girardeau