Provider Demographics
NPI:1124555453
Name:GLISSON, TYLER JEFFREY (FNP-C, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:JEFFREY
Last Name:GLISSON
Suffix:
Gender:M
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 BILTMORE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4504
Mailing Address - Country:US
Mailing Address - Phone:828-318-5241
Mailing Address - Fax:
Practice Address - Street 1:356 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4504
Practice Address - Country:US
Practice Address - Phone:828-254-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012666363LP0808X
FL9347781363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily