=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568234375
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TYLER ALEXANDER ZUK FNP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2023
-----------------------------------------------------
Last Update Date | 10/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 BUNKER HILL DR
-----------------------------------------------------
City | AITKIN
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56431-1865
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 218-927-5537
-----------------------------------------------------
Fax | 218-927-5538
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 BUNKER HILL DR
-----------------------------------------------------
City | AITKIN
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56431-1865
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 218-927-2121
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 10896
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------