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NPI Code Detail

MEDICARE: TYLER JAMES PATTEN RN

MEDICARE: TYLER JAMES PATTEN RN
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
1163WS0200XSchool Registered Nurse97623NE

General Provider Information

NPI Number : 1851119853
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER JAMES PATTEN RN
Provider Business Mailing Address
First Line : 3109 PEDERSEN DR
Second Line :
City : OMAHA
State : NE
Zip : 68144-3912
Country : US
Telephone Number : 531-299-1880
Fax Number :
Provider Business Practice Location Address
First Line : 3109 PEDERSEN DR
Second Line :
City : OMAHA
State : NE
Zip : 68144-3912
Country : US
Telephone Number : 531-299-1880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2024
Last Update Date : 09/30/2024

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