Provider Demographics
NPI:1124241716
Name:TYREE, ANN (NP, MSN)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:TYREE
Suffix:
Gender:F
Credentials:NP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 EAST 28TH STREET
Mailing Address - Street 2:SUITE 418
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2657
Mailing Address - Country:US
Mailing Address - Phone:562-997-4070
Mailing Address - Fax:562-997-4090
Practice Address - Street 1:701 EAST 28TH STREET
Practice Address - Street 2:SUITE 418
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2657
Practice Address - Country:US
Practice Address - Phone:562-997-4070
Practice Address - Fax:562-997-4090
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA299935OtherRN LICENSE
CA299935OtherRN LICENSE