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General NPI Number Information
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NPI Number | 1285335018
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Entity Type | Individual
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Provider Name | TYLER JAMES OSTLUND FNP-C
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Gender | Male
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Dates
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Enumeration Date | 03/17/2023
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 691 E 400 N STE 110
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City | VINEYARD
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State | UT
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Zip | 84059-7509
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Country | US
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Telephone | 385-666-9600
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Fax | 385-666-9601
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Provider Business Mailing Address
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Address Line | PO BOX 912042
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City | ST GEORGE
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State | UT
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Zip | 84791-2042
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Country | US
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Telephone | 435-215-0230
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11703146-4405
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License Number State | UT
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