Individual
KATHRYN M TYNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5757 PLAZA DR, CYPRESS, CA 90630-5000
(763) 361-7002
Mailing address
3672 N WHITE PEARL LN, TUCSON, AZ 85749-9707
(520) 245-3326
(520) 751-6448
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
200550137NP
OR
363LA2200X
Adult Health Nurse Practitioner
Primary
RN081159
AZ
363LG0600X
Gerontology Nurse Practitioner
200550138NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
440777
—
AZ
Enumeration date
11/02/2005
Last updated
06/04/2021
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