Moore, Tyler Herchell
Moore, Tyler Herchell is an individual health care provider with primary practice located at 37 S 2Nd E Ste 101 , Rexburg ID 83440-1906. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Moore, Tyler Herchell can be contacted via phone (208) 356-0234.Contact Information
Primary practice address
37 S 2Nd E Ste 101
Rexburg ID 83440-1906
Phone: (208) 356-0234
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 72632 | Idaho |
Profile Details
| NPI number | 1801532106 |
|---|---|
| LBN Legal business name | Moore, Tyler Herchell |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2022 |
| Last updated | May 10th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801532106 | NPPES |
| Idaho | Other | 72632 | STATE BOARD OF NURSING |
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