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General NPI Number Information
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NPI Number | 1902144629
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Entity Type | Individual
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Provider Name | HEATHER FAITH TYER PA-C, MMSC, MPH
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Gender | Female
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 317 SAINT FRANCIS DR STE 220
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City | GREENVILLE
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State | SC
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Zip | 29601-3976
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Country | US
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Telephone | 864-255-1901
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Fax |
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Provider Business Mailing Address
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Address Line | 735 JOYNER AVE
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City | TUPELO
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State | MS
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Zip | 38804-2523
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Country | US
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Telephone | 336-207-1479
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085004618
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00259
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4081
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License Number State | SC
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