Provider Demographics
NPI:1083389324
Name:TYREE, RONALD JAMES (PMHNP)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JAMES
Last Name:TYREE
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 E STEPHEN DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-1862
Mailing Address - Country:US
Mailing Address - Phone:302-478-6199
Mailing Address - Fax:
Practice Address - Street 1:410 FOULK RD STE 105
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3835
Practice Address - Country:US
Practice Address - Phone:302-478-6199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0010261363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health