# KATHRYN M TYNAN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1508857095
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 200550137NP | OR | — |
| 363LA2200X | Adult Health Nurse Practitioner | RN081159 | AZ | Yes |
| 363LG0600X | Gerontology Nurse Practitioner | 200550138NP | OR | — |

## Other

- **Enumeration date:** 11/02/2005
- **Last updated:** 06/04/2021