Provider Demographics
NPI:1427717974
Name:TYLER, AMBER KIARA (FNP-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:KIARA
Last Name:TYLER
Suffix:
Gender:F
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 1:5301 WILLIAM D TATE AVE
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7357
Mailing Address - Country:US
Mailing Address - Phone:817-251-2101
Mailing Address - Fax:
Practice Address - Street 1:5301 WILLIAM D TATE AVE
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7357
Practice Address - Country:US
Practice Address - Phone:174-212-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1058123363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMT7004334OtherDEA