Individual
ANGELA TYNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2712 TYLER CT, ORANGE PARK, FL 32065-7676
(904) 521-3619
Mailing address
2712 TYLER CT, ORANGE PARK, FL 32065-7676
(904) 521-3619
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
1-091820
AL
163WG0000X
General Practice Registered Nurse
Primary
RN 9340040
FL
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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