Individual
TYLER JOHN WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
(484) 476-2000
Mailing address
737 HAMEL AVE, GLENSIDE, PA 19038-2621
(630) 639-1590
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN661619
PA
363LA2100X
Acute Care Nurse Practitioner
Primary
SP024405
PA
Other
Enumeration date
09/09/2021
Last updated
11/15/2021
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