Tyler Anne Eickholt, RN, PHN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95113008 Issued in CA

Practice address

367 N Magnolia Ave Ste 101
El Cajon, CA 92020-3995

Phone

(619) 441-6500

NPI assigned

Mar 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1225530249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 SWIFT AVE APT 1/2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921046613",
            "telephone_number": "484-995-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 N MAGNOLIA AVE STE 101",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203995",
            "telephone_number": "619-441-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICKHOLT",
        "first_name": "TYLER",
        "middle_name": "ANNE",
        "credential": "RN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95113008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Anthony Edwards Sr.
• Anne Edwardson
• Eggleton & Langton Physical Therapy Management Services
• Nathan Ehrenberger, PTA
• Adam Eichorst
• Almog Eilat
• Ava Eisa
• Eje Academies
• Eje Elementary Academy
• Catherine William Faltaos Ekladios, MD

• All providers in El Cajon, CA
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; 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.