Individual
MRS. DALTREY ANNE TYREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP, APRN
Contact information
Practice address
730 FAIRVIEW AVE STE B3, BOWLING GREEN, KY 42101-2365
(270) 715-0665
(270) 550-2008
Mailing address
730 FAIRVIEW AVE STE B3, BOWLING GREEN, KY 42101-2365
(270) 715-0665
(270) 550-2008
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4688P
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3004688
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
554523
—
AZ
05
—
7100579550
—
KY
Enumeration date
10/31/2005
Last updated
01/30/2025
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