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NPI Code Detail

MEDICARE: EDUARD TSYRULNYKOV APNP

MEDICARE: EDUARD TSYRULNYKOV APNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner95019975CA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner9921-33WI
3363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11016687FL
4363L00000XNurse Practitioner9921-33WI
5163W00000XRegistered Nurse200181WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720213812
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDUARD TSYRULNYKOV APNP
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 262-999-3495
Fax Number :
Provider Business Practice Location Address
First Line : 11649 N PORT WASHINGTON RD STE 221
Second Line :
City : MEQUON
State : WI
Zip : 53092-3461
Country : US
Telephone Number : 262-999-3495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2009
Last Update Date : 05/27/2026

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