Provider Demographics
NPI:1851119853
Name:PATTEN, TYLER JAMES (RN)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JAMES
Last Name:PATTEN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 PEDERSEN DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3912
Mailing Address - Country:US
Mailing Address - Phone:531-299-1880
Mailing Address - Fax:
Practice Address - Street 1:3109 PEDERSEN DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3912
Practice Address - Country:US
Practice Address - Phone:531-299-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE97623163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool