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NPI Code Detail

MEDICARE: MR. TYLER FEUERBORN APRN-C

MEDICARE: MR. TYLER FEUERBORN APRN-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerARNP9407120FL
2363LP2300XPrimary Care Nurse PractitionerAPRN9407120FL
3363L00000XNurse Practitioner1061932TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366941650
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TYLER FEUERBORN APRN-C
Provider Business Mailing Address
First Line : 1515 S BUCKNER BLVD STE 141
Second Line :
City : DALLAS
State : TX
Zip : 75217-1794
Country : US
Telephone Number : 214-974-9126
Fax Number : 469-574-0383
Provider Business Practice Location Address
First Line : 1515 S BUCKNER BLVD STE 141
Second Line :
City : DALLAS
State : TX
Zip : 75217-1794
Country : US
Telephone Number : 214-974-9126
Fax Number : 469-574-0383
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2018
Last Update Date : 01/02/2024

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