MEDICARE: KAHLAN TYLER KEYS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WF0300X	Flight Registered Nurse	R899045	MS

General Provider Information

NPI Number	:	1710849153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAHLAN TYLER KEYS NP

Provider Business Mailing Address
First Line	:	1 SWEETGRASS LN
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3407
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 SWEETGRASS LN
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3407
Country	:	US
Telephone Number	:	228-990-2557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2025
Last Update Date	:	11/24/2025

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