Healthcare Provider Details

I. General information

NPI: 1992018105
Provider Name (Legal Business Name): TYLER JOSEPH SCHMIDT FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BUCK CREEK RD STE 100
AVON CO
81620-5428
US

IV. Provider business mailing address

PO BOX 6347
EAGLE CO
81631-0018
US

V. Phone/Fax

Practice location:
  • Phone: 970-926-6340
  • Fax: 970-926-6348
Mailing address:
  • Phone: 970-926-6350
  • Fax: 970-926-6348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10325
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: