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Individual

MR. TYLER JOSEPH ALICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
1633 FILLMORE ST STE GL1, DENVER, CO 80206-1546
(303) 953-6600
(303) 781-4333
Mailing address
1633 FILLMORE ST STE GL1, DENVER, CO 80206-1546
(303) 953-6600
(303) 781-4333

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APN.0990909-NP
CO
363LF0000X
Family Nurse Practitioner
3259
SC
363LF0000X
Family Nurse Practitioner
LB-0000216
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
372048
SC
01
7124
MEDICARE ID- TYPE UNSPECI
SC
Enumeration date
12/13/2007
Last updated
02/05/2014
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