Provider Demographics
NPI:1073049722
Name:DEAN-OUSLEY, TYRA (EDD, APN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:TYRA
Middle Name:
Last Name:DEAN-OUSLEY
Suffix:
Gender:F
Credentials:EDD, APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11228 S EMERALD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-4707
Mailing Address - Country:US
Mailing Address - Phone:773-425-9946
Mailing Address - Fax:
Practice Address - Street 1:235 E PRINCETON ST STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5555
Practice Address - Country:US
Practice Address - Phone:407-303-1444
Practice Address - Fax:407-303-1446
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023314363LF0000X
IL209015881363LF0000X
IL277002442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily