Tyler Owen Pickens, RN, BSN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

RN9392671 Issued in FL

Practice address

100 N Main St
Chattahoochee, FL 32324-1107

Phone

(850) 663-7905

Fax

(850) 663-7897

NPI assigned

Mar 25, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1043847346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 HAYWOOD DR",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324282184",
            "telephone_number": "850-209-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MAIN ST",
            "city": "CHATTAHOOCHEE",
            "state": "FL",
            "postal_code": "323241107",
            "telephone_number": "850-663-7905",
            "fax_number": "850-663-7897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKENS",
        "first_name": "TYLER",
        "middle_name": "OWEN",
        "name_prefix": "Mr.",
        "credential": "RN, BSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "RN9392671",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "FL",
            "license": "RN9392671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rasik Patel, M.D.
• Rosalee Jenifer Peckoo, M.D.
• Michael Jon Peel, ARNP
• Gholam Reza Pezeshkian, M.D.
• Boris Phung, M.D.
• Luciana Pittman
• Sandra Juliana Raheb, M.D.
• Ellen E. Resch, PH.D.
• Rhonda Reuben Aprn LLC
• Torria Richardson, LMHC

• Adult Psychiatric/Mental Health Registered Nurse in Chattahoochee, FL
• Providers in Chattahoochee, FL by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.