Provider Demographics
NPI:1932675501
Name:TYLER, MEGAN GARDNER (ARNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:GARDNER
Last Name:TYLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4250 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-1917
Mailing Address - Country:US
Mailing Address - Phone:850-526-5300
Mailing Address - Fax:
Practice Address - Street 1:4318 5TH AVE
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-2182
Practice Address - Country:US
Practice Address - Phone:850-526-5300
Practice Address - Fax:850-526-5001
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9366358363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily