Healthcare Provider Details

I. General information

NPI: 1245184340
Provider Name (Legal Business Name): TYLER NICOLE GARY MSN,AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PRINCETON AVE SW STE 310
BIRMINGHAM AL
35211-1307
US

IV. Provider business mailing address

801 PRINCETON AVE SW STE 310
BIRMINGHAM AL
35211-1307
US

V. Phone/Fax

Practice location:
  • Phone: 205-787-8676
  • Fax: 205-785-7944
Mailing address:
  • Phone: 205-787-8676
  • Fax: 205-785-7944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-179062
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1-179062
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: