Individual
TYLER ZACHARY GILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
(617) 247-7555
(617) 638-0033
Mailing address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
(617) 247-7555
(617) 638-0033
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
RN2328949
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2328949
MA
Other
Enumeration date
03/05/2020
Last updated
09/16/2024
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