Provider Demographics
NPI:1356109524
Name:ANDREW, TYLER (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:ANDREW
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 331524
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37133-1524
Mailing Address - Country:US
Mailing Address - Phone:615-569-8636
Mailing Address - Fax:
Practice Address - Street 1:745 S CHURCH ST STE 303
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4963
Practice Address - Country:US
Practice Address - Phone:615-569-8636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4017251363LP0808X
TN35915363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health