Basic Information
| Provider Information | |||||||||
| NPI: | 1477124592 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCGREW | ||||||||
| FirstName: | TYNAYA | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1610 CENTER ST STE A | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366041543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514397882 | ||||||||
| FaxNumber: | 2514329013 | ||||||||
| Practice Location | |||||||||
| Address1: | 1610 CENTER ST STE A | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366041543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514397882 | ||||||||
| FaxNumber: | 2514329013 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2021 | ||||||||
| LastUpdateDate: | 07/09/2021 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 07/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 1-167703 | AL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.