Provider Demographics
NPI:1821682154
Name:TYLER, ABIGAIL S (CRNP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:S
Last Name:TYLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:S
Other - Last Name:STOKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:6600 TIMRA CIR
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-1925
Mailing Address - Country:US
Mailing Address - Phone:215-603-4513
Mailing Address - Fax:
Practice Address - Street 1:801 WASHINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147
Practice Address - Country:US
Practice Address - Phone:267-519-9353
Practice Address - Fax:276-519-8120
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily