Provider Demographics
NPI:1407162621
Name:RN FIRST ASSIST OF TYLER
Entity Type:Organization
Organization Name:RN FIRST ASSIST OF TYLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAWN
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:903-752-5555
Mailing Address - Street 1:11924 COUNTY ROAD 2298
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75707-4948
Mailing Address - Country:US
Mailing Address - Phone:903-752-5555
Mailing Address - Fax:888-329-6432
Practice Address - Street 1:11924 COUNTY ROAD 2298
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75707-4948
Practice Address - Country:US
Practice Address - Phone:903-752-5555
Practice Address - Fax:888-329-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX618259163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty