# DR. TYRA TANNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1326340928
- **Gender:** F
- **Credential:** DNP, RD, ANP, CNS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | 2010029866 | MO | — |
| 163W00000X | Registered Nurse | 0001206597 | VA | — |
| 363L00000X | Nurse Practitioner | 0024172296 | VA | — |
| 363LA2200X | Adult Health Nurse Practitioner | 0024172296 | VA | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 0024172296 | VA | — |
| 364SA2200X | Adult Health Clinical Nurse Specialist | 0015000947 | VA | — |

## Other

- **Enumeration date:** 12/02/2010
- **Last updated:** 04/03/2025