Individual
MR. TYLER JOE FADORSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
245 GOVERNORS DR SE, HUNTSVILLE, AL 35801-2700
(256) 265-9889
Mailing address
245 GOVERNORS DR SE, HUNTSVILLE, AL 35801-2700
(256) 265-9889
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-145198
AL
363LP0222X
Critical Care Pediatric Nurse Practitioner
1-145198
AL
Other
Enumeration date
08/13/2020
Last updated
08/10/2023
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