Provider Demographics
NPI:1588813950
Name:TYLER, PATRICIA A (STNA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:TYLER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 WHITBY RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44112-2347
Mailing Address - Country:US
Mailing Address - Phone:440-463-6868
Mailing Address - Fax:
Practice Address - Street 1:965 WHITBY RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44112-2347
Practice Address - Country:US
Practice Address - Phone:440-463-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363508461189376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH263325918Other363508461189