Individual
TYRA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
NURSE PRACTITIONER
Contact information
Practice address
55 WILLOW LN, ENGLISHTOWN, NJ 07726-8434
(732) 612-9833
Mailing address
148 W 8TH AVE, ROSELLE, NJ 07203-1942
(732) 598-3254
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ15119100
NJ
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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