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Individual
TYLER TERRY
Active
Individual
TYLER TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
5011884
NC
363LF0000X
Family Nurse Practitioner
5011884
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5011884
NC MEDICAL BOARD
NC
Enumeration date
06/17/2019
Last updated
04/22/2022
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