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NPI Code Detail

MEDICARE: MS. PATRICIA DANIELL TYLER LPN

MEDICARE:  MS. PATRICIA DANIELL TYLER  LPN
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
1164W00000XLicensed Practical Nurse142978-M-IVOH

General Provider Information

NPI Number : 1821423997
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA DANIELL TYLER LPN
Provider Business Mailing Address
First Line : 1646 SPRING GARDEN AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3538
Country : US
Telephone Number : 216-598-0550
Fax Number :
Provider Business Practice Location Address
First Line : 1646 SPRING GARDEN AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3538
Country : US
Telephone Number : 216-598-0550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2013
Last Update Date : 09/09/2013

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Directions to “ MS. PATRICIA DANIELL TYLER LPN” Practice Location

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