Provider Demographics
NPI:1497988695
Name:TYLER, NICOLE LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:LYNN
Last Name:TYLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 PALOMA HTS
Mailing Address - Street 2:APARTMENT 301
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3270
Mailing Address - Country:US
Mailing Address - Phone:910-603-9943
Mailing Address - Fax:
Practice Address - Street 1:162 PALOMA HTS
Practice Address - Street 2:APARTMENT 301
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3270
Practice Address - Country:US
Practice Address - Phone:910-603-9943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO192123163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse