Individual
MR. TYLER JOSEPH ALICKS
Active
Individual
MR. TYLER JOSEPH ALICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
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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