Individual
TYLER L ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 HOSPITAL DR SW, HUNTSVILLE, AL 35801-6455
(256) 429-5071
(256) 429-4674
Mailing address
PO BOX 52404, LAFAYETTE, LA 70505-2404
(256) 429-5071
(256) 429-4674
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN169321
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
1-113384
AL
367500000X
Certified Registered Nurse Anesthetist
APN16057
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003114495A
—
GA
05
—
133589
—
AL
01
—
4306609
BCBS OF TN
TN
Enumeration date
08/18/2011
Last updated
09/16/2013
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