Active NPI
Marie Ann Tyner, CNA
- Nurse's Aide
- Phenix City, AL
National Provider Identifier
1104336502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- CN0000064156
- Practice address
- 2406 Midway Dr
Phenix City, AL 36869-7145 - Phone
- (706) 332-0320
- NPI assigned
- Oct 11, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | CN0000064156 | GA | Primary |
Addresses
Primary practice location
2406 Midway Dr
Phenix City, AL 36869-7145
Mailing address
2406 Midway Dr
Phenix City, AL 36869-7145
Phone (706) 332-0320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CN0000064156 | GA | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507680000000",
"number": "1104336502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2406 MIDWAY DR",
"city": "PHENIX CITY",
"state": "AL",
"postal_code": "368697145",
"telephone_number": "706-332-0320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2406 MIDWAY DR",
"city": "PHENIX CITY",
"state": "AL",
"postal_code": "368697145",
"telephone_number": "706-332-0320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYNER",
"first_name": "MARIE",
"middle_name": "ANN",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-11",
"last_updated": "2017-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "GA",
"license": "CN0000064156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phenix City, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.