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Individual
TYLER BURNS
Active
Individual
TYLER BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA061651
PA
363A00000X
Physician Assistant
OA005283
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103826689
—
PA
Enumeration date
07/10/2020
Last updated
11/13/2020
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