Individual
TYLER FORNWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
NP
Contact information
Practice address
206 E BROWN ST, EAST STROUDSBURG, PA 18301-3006
(570) 421-4000
Mailing address
2100 MACK BLVD FL 4, ALLENTOWN, PA 18103-5622
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN724363
PA
363LA2100X
Acute Care Nurse Practitioner
Primary
SP033949
PA
Other
Enumeration date
07/23/2025
Last updated
10/08/2025
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