Healthcare Provider Details

I. General information

NPI: 1538085188
Provider Name (Legal Business Name): TYLER MARCUS HOLMES PARAMEDIC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 STANLEY RD
DUMONT CO
80436-5097
US

IV. Provider business mailing address

11082 LONE PNES
LITTLETON CO
80125-9291
US

V. Phone/Fax

Practice location:
  • Phone: 720-403-7047
  • Fax:
Mailing address:
  • Phone: 720-403-7047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberQ201094
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: