Provider Demographics
NPI:1437942851
Name:BARTLEY, TYLER RAYMOND
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:RAYMOND
Last Name:BARTLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-6585
Mailing Address - Country:US
Mailing Address - Phone:402-933-0680
Mailing Address - Fax:
Practice Address - Street 1:215 S MAIN ST
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-6585
Practice Address - Country:US
Practice Address - Phone:402-933-0680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion