Individual
TYLER KEITH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
6901 MEDICAL PKWY, WACO, TX 76712-7910
(254) 751-4180
Mailing address
6901 MEDICAL PKWY, WACO, TX 76712-7910
(254) 751-4180
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1165582
TX
363LF0000X
Family Nurse Practitioner
1165582
TX
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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