Warren, Tyler Scott

Warren, Tyler Scott is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Warren, Tyler Scott can be contacted via phone (774) 443-7552.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Phone: (774) 443-7552
Fax: (774) 441-6086
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine 363LC0200X RN2276898 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN2276898 Massachusetts

Profile Details

NPI number 1659823136
LBN Legal business name Warren, Tyler Scott
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2016
Last updated Nov 16th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659823136 NPPES
Massachusetts MEDICAID 110119650A

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