Healthcare Provider Details

I. General information

NPI: 1962367227
Provider Name (Legal Business Name): NATHAN WILLIAM SEWELL APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 E HOUSTON ST STE 100
TYLER TX
75702-8363
US

IV. Provider business mailing address

201 ATLANTA AVE
TYLER TX
75703-3714
US

V. Phone/Fax

Practice location:
  • Phone: 903-593-8441
  • Fax:
Mailing address:
  • Phone: 254-541-9208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1219010
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: