Healthcare Provider Details

I. General information

NPI: 1366113318
Provider Name (Legal Business Name): TYLER JAMES HARDING MSN, APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 N SAINT FRANCIS AVE
WICHITA KS
67214-3821
US

IV. Provider business mailing address

929 N SAINT FRANCIS AVE
WICHITA KS
67214-3821
US

V. Phone/Fax

Practice location:
  • Phone: 316-268-5922
  • Fax: 316-291-7964
Mailing address:
  • Phone: 316-268-5922
  • Fax: 316-291-7964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number53-80560-061
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number53-80560-061
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number53-80560-061
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number53-80560-061
License Number StateKS
# 5
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-80560-061
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: