Provider Demographics
NPI:1326652447
Name:WHYTE, TYECE TYESHA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:TYECE
Middle Name:TYESHA
Last Name:WHYTE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 STANLEY AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1105
Mailing Address - Country:US
Mailing Address - Phone:347-636-4031
Mailing Address - Fax:
Practice Address - Street 1:157 STANLEY AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-1105
Practice Address - Country:US
Practice Address - Phone:347-636-4031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY795400-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY795400-01OtherNURSE