Provider Demographics
NPI:1366697435
Name:TYLER, BRENDA LEE (BSN PHN)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LEE
Last Name:TYLER
Suffix:
Gender:F
Credentials:BSN PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4599
Mailing Address - Country:US
Mailing Address - Phone:559-624-1097
Mailing Address - Fax:559-624-1086
Practice Address - Street 1:2325 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4599
Practice Address - Country:US
Practice Address - Phone:559-624-1097
Practice Address - Fax:559-624-1086
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN529679163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health