Individual
TYLER JAMES BAGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
661 W VIA DE PALMAS, SAN TAN VALLEY, AZ 85140-7381
(530) 868-7509
Mailing address
661 W VIA DE PALMAS, SAN TAN VALLEY, AZ 85140-7381
(530) 868-7509
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
249724
AZ
367500000X
Certified Registered Nurse Anesthetist
95000079
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
249724
ARIZONA
AZ
Enumeration date
02/27/2013
Last updated
05/31/2024
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