Provider Demographics
NPI:1184222606
Name:MAPLES, TYLER (RN, BSN)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:MAPLES
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 KARROW ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-8001
Mailing Address - Country:US
Mailing Address - Phone:865-216-8276
Mailing Address - Fax:
Practice Address - Street 1:605 KARROW ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-8001
Practice Address - Country:US
Practice Address - Phone:865-216-8276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN204696163W00000X
KY4008691367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse