Individual
TYRA A GOOGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
850 HARRISON AVE., YACC 4, BOSTON, MA 02118
(617) 414-4359
Mailing address
70 SHEAFE ST, MALDEN, MA 02148-6029
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2333352
MA
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
2333352
MA
Other
Enumeration date
02/19/2026
Last updated
04/06/2026
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