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General NPI Number Information
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NPI Number | 1912507500
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Entity Type | Individual
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Provider Name | CA'SEEM TYLER MSN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 11/01/2020
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 9375 CHESAPEAKE ST STE 219
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City | LA PLATA
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State | MD
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Zip | 20646-3654
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Country | US
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Telephone | 240-617-0212
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Fax | 877-775-0210
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Provider Business Mailing Address
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Address Line | 9375 CHESAPEAKE ST STE 219
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City | LA PLATA
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State | MD
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Zip | 20646-3654
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Country | US
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Telephone | 240-617-0212
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Fax | 877-775-0210
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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 | R219935
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License Number State | MD
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