Provider Demographics
NPI:1043190309
Name:MORRISON-VIDAR, TYLYNN LEIGH
Entity type:Individual
Prefix:
First Name:TYLYNN
Middle Name:LEIGH
Last Name:MORRISON-VIDAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N10707 MAIL ROUTE RD
Mailing Address - Street 2:
Mailing Address - City:TOMAHAWK
Mailing Address - State:WI
Mailing Address - Zip Code:54487-9101
Mailing Address - Country:US
Mailing Address - Phone:608-577-7604
Mailing Address - Fax:
Practice Address - Street 1:N10707 MAIL ROUTE RD
Practice Address - Street 2:
Practice Address - City:TOMAHAWK
Practice Address - State:WI
Practice Address - Zip Code:54487-9101
Practice Address - Country:US
Practice Address - Phone:608-577-7604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife