NPI Profile for Dr TYLER WILLIS in COUPEVILLE, WA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Acute Care |
363LA2100X | 50 | Nurse Practitioner | |
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner |
| NPI # | 1689340515 |
|
| Status | Active | |
| Credentials | DNP, NP | |
| Entity | Individual | |
| Enumeration date | 08/19/2021 | |
| Last updated | 04/22/2024 - About 2 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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TYLER WILLIS
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