Kimberly Brennan Tyler, ANP | |
3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | |
(506) 494-9000 | |
Not Available |
Full Name | Kimberly Brennan Tyler |
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Gender | Female |
Speciality | Nurse Practitioner - Adult Health |
Location | 3181 Sw Sam Jackson Park Rd, Portland, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427066976 | NPI | - | NPPES |
023050 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LA2200X | Nurse Practitioner - Adult Health | 200550020NP (Oregon) | Secondary |
363LA2200X | Nurse Practitioner - Adult Health | 200540047RN (Oregon) | Primary |
Entity Name | Providence Health & Services Oregon |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053862714 PECOS PAC ID: 7315856010 Enrollment ID: O20040304001330 |
Mailing Address | Practice Location Address |
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Kimberly Brennan Tyler, ANP 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 Ph: (506) 494-9000 | Kimberly Brennan Tyler, ANP 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 Ph: (506) 494-9000 |
Mrs. Anjalee Nix Rowe, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-3988 | |
Ms. Susan Irene Smith, RN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5100 Sw Macadam Ave, Suite 200, Portland, OR 97239 Phone: 971-202-5500 Fax: 971-202-5555 | |
Iva Juric, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239 Phone: 503-494-4808 | |
Ms. Jessica A Dudley, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3550 N Interstate Ave, Portland, OR 97227 Phone: 503-746-1575 | |
Summer Morgan Massina, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 721 Nw 9th Ave Ste 100, Portland, OR 97209 Phone: 503-525-0090 | |
Dr. Jeffery Wise, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1834 Nw 25th Ave Apt 504, Portland, OR 97210 Phone: 971-354-9242 | |
A'lissa Richards, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12121 E Burnside St, Portland, OR 97216 Phone: 971-361-7700 |