Individual
TYLER L ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
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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