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General NPI Number Information
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NPI Number | 1548715089
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Entity Type | Individual
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Provider Name | COLLYNNE TYER APRN
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Gender | Female
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Dates
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Enumeration Date | 08/24/2016
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 4200 REGENT ST STE 200
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City | COLUMBUS
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State | OH
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Zip | 43219-6229
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Country | US
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Telephone | 877-870-1775
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Fax | 614-968-8840
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Provider Business Mailing Address
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Address Line | 4291 NEPTUNE DR SE
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City | ST PETERSBURG
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State | FL
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Zip | 33705-4320
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9385159
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License Number State | FL
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