Provider Demographics
NPI:1992053177
Name:SPLETZER, TYLER EDWARD (FNP-C)
Entity type:Individual
Prefix:MR
First Name:TYLER
Middle Name:EDWARD
Last Name:SPLETZER
Suffix:
Gender:M
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 1:2741 ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-3833
Mailing Address - Country:US
Mailing Address - Phone:715-735-3627
Mailing Address - Fax:
Practice Address - Street 1:2741 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-3833
Practice Address - Country:US
Practice Address - Phone:715-735-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI151338-030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily