Provider Demographics
NPI:1598586976
Name:TERI TYNES PSYCHIATRIC NURSE PRACTITIONER PLLC
Entity type:Organization
Organization Name:TERI TYNES PSYCHIATRIC NURSE PRACTITIONER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:TYNES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:940-487-9800
Mailing Address - Street 1:8813 N TARRANT PKWY STE 218
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-8410
Mailing Address - Country:US
Mailing Address - Phone:940-487-9800
Mailing Address - Fax:
Practice Address - Street 1:8813 N TARRANT PKWY STE 218
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8410
Practice Address - Country:US
Practice Address - Phone:940-487-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty