Individual
KAY L TYBERG
Active
Individual
KAY L TYBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2006001671
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025N3TY
BLUE CROSS BLUE SHIELD
MN
01
—
04-08776
MEDICA
MN
05
—
575324400
—
MN
Enumeration date
05/31/2006
Last updated
11/02/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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