Provider Demographics
NPI:1710629373
Name:ALBRO, TYWANNA A (FNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:TYWANNA
Middle Name:A
Last Name:ALBRO
Suffix:
Gender:F
Credentials:FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 HARBOUR PLACE DR UNIT 2115
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-6810
Mailing Address - Country:US
Mailing Address - Phone:404-991-8723
Mailing Address - Fax:
Practice Address - Street 1:5825 ARGERIAN DR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4140
Practice Address - Country:US
Practice Address - Phone:404-991-8723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9512677363L00000X
FLAPRN11028503363LP0808X
FL9512677363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty