Healthcare Provider Details

I. General information

NPI: 1316827215
Provider Name (Legal Business Name): TYLER ADKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TYLER JEBBIA

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 SPRING ARBOR RD
JACKSON MI
49203-2878
US

IV. Provider business mailing address

8345 N RIVER RD
FREELAND MI
48623-8715
US

V. Phone/Fax

Practice location:
  • Phone: 517-539-6111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: