Provider Demographics
NPI:1003636747
Name:ZYBURA, TYLER ANN (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:TYLER
Middle Name:ANN
Last Name:ZYBURA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 STOWE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-8875
Mailing Address - Country:US
Mailing Address - Phone:619-573-0607
Mailing Address - Fax:760-896-6883
Practice Address - Street 1:12700 STOWE DR STE 110
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-8875
Practice Address - Country:US
Practice Address - Phone:619-573-0607
Practice Address - Fax:760-896-6883
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95321478163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse