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Individual

MS. VICTORIA LYNN TYRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, FNP-C

Contact information

Practice address
N61W23044 HARRYS WAY, SUSSEX, WI 53089-3995
(866) 275-3737
(414) 566-7613
Mailing address
1713 SONNET DR, GRAPEVINE, TX 76051-2706
(972) 977-9421

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024181497
VA
363LF0000X
Family Nurse Practitioner
0030325
OH
363LF0000X
Family Nurse Practitioner
64317
NM
363LF0000X
Family Nurse Practitioner
71009011B
IN
363LF0000X
Family Nurse Practitioner
903244
MS
363LF0000X
Family Nurse Practitioner
95025997
CA
363LF0000X
Family Nurse Practitioner
Primary
AP117203
TX
363LF0000X
Family Nurse Practitioner
APNP9249
WI
363LF0000X
Family Nurse Practitioner
F349235-01
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
308376801
TX
Enumeration date
08/27/2008
Last updated
01/24/2025
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