Provider Demographics
NPI:1285335018
Name:OSTLUND, TYLER JAMES (FNP-C)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JAMES
Last Name:OSTLUND
Suffix:
Gender:
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:PO BOX 912042
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84791-2042
Mailing Address - Country:US
Mailing Address - Phone:435-215-0230
Mailing Address - Fax:
Practice Address - Street 1:691 E 400 N STE 110
Practice Address - Street 2:
Practice Address - City:VINEYARD
Practice Address - State:UT
Practice Address - Zip Code:84059-7509
Practice Address - Country:US
Practice Address - Phone:385-666-9600
Practice Address - Fax:385-666-9601
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11703146-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner