Provider Demographics
NPI:1306825773
Name:TYLER, SHIRLEY JEAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:JEAN
Last Name:TYLER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1650 COCHRANE CIR
Mailing Address - Street 2:EVANS FAMILY MEDICINE CLINIC
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4603
Mailing Address - Country:US
Mailing Address - Phone:719-524-4068
Mailing Address - Fax:719-526-7312
Practice Address - Street 1:1650 COCHRANE CIR
Practice Address - Street 2:EVANS FAMILY MEDICINE CLINIC
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4603
Practice Address - Country:US
Practice Address - Phone:719-524-4068
Practice Address - Fax:719-526-7312
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2010-11-02
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Provider Licenses
StateLicense IDTaxonomies
CO875363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant