Basic Information
| Provider Information | |||||||||
| NPI: | 1114681053 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TYLER | ||||||||
| FirstName: | HALEY | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | APRN-FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 83 | ||||||||
| Address2: | |||||||||
| City: | CORNING | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724220083 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8708573334 | ||||||||
| FaxNumber: | 8708579934 | ||||||||
| Practice Location | |||||||||
| Address1: | 308 HIGHWAY 62 W | ||||||||
| Address2: | |||||||||
| City: | ASH FLAT | ||||||||
| State: | AR | ||||||||
| PostalCode: | 725139415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709942202 | ||||||||
| FaxNumber: | 8709942328 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2021 | ||||||||
| LastUpdateDate: | 07/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 217852 | AR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP2300X | 217852 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.