Basic Information
| Provider Information | |||||||||
| NPI: | 1104550565 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAAG | ||||||||
| FirstName: | TYLER | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9288 SHAFFER ST | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458400202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198908840 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 PROGRESSIVE DR | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS GROVE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458309620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196596010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2022 | ||||||||
| LastUpdateDate: | 08/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | RN.439039 | OH | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 363LF0000X | APRN.CNP.0032202 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.