NPI Profile for TYLIE D ROMAN in NAMPA, ID.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Gerontology |
363LG0600X | 50 | Nurse Practitioner | |
Acute Care |
363LA2100X | 50 | Nurse Practitioner | |
Registered Nurse |
163W00000X |
| NPI # | 1740981943 |
|
| Status | Active | |
| Credentials | CNP (Certified Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 03/14/2023 | |
| Last updated | 01/23/2025 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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TYLIE D ROMAN
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