Provider Demographics
NPI:1720693161
Name:USHER, TYLER DEAN (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:TYLER
Middle Name:DEAN
Last Name:USHER
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 STONE BRIAR DR N
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-5801
Mailing Address - Country:US
Mailing Address - Phone:903-348-8159
Mailing Address - Fax:
Practice Address - Street 1:109 STONE BRIAR DR N
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-5801
Practice Address - Country:US
Practice Address - Phone:903-348-8159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-12
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1010282363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner