# TYLER AUSTIN WILLIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1205663069
- **Gender:** Man
- **Credential:** RN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC0200X | Critical Care Medicine Registered Nurse | RN61080655 | WA | Yes |
| 364SA2100X | Acute Care Clinical Nurse Specialist | RN61080655 | WA | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | RN61080655 | WA | — |

## Other

- **Enumeration date:** 09/16/2024
- **Last updated:** 09/16/2024