Provider Demographics
NPI:1356808265
Name:TYREE, MEGAN (APRN,FNP-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:TYREE
Suffix:
Gender:
Credentials:APRN,FNP-C
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 211699
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-3699
Mailing Address - Country:US
Mailing Address - Phone:866-849-0692
Mailing Address - Fax:888-973-8821
Practice Address - Street 1:3623 CROSSINGS DR STE 206
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7101
Practice Address - Country:US
Practice Address - Phone:866-849-0692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN177699163W00000X
TN37489363LF0000X
SC29771363LF0000X
TX1179578363LF0000X
AL3-002009363LF0000X
OH0037866363LF0000X
CO0101247363LF0000X
IN71015984A363LF0000X
MS907100363LF0000X
OR10019878363LF0000X
HIAPRN-4561363LF0000X
FLAPRN11035623363LF0000X
WAAP61622331363LF0000X
AR230979363LF0000X
AZ220085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ239915Medicaid