Tyler Tull

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

453333 Issued in OH

Practice address

435 Jackson Ave NE
Brewster, OH 44613-1119

Phone

(330) 933-4508

NPI assigned

Aug 1, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1295564672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 JACKSON AVE NE",
            "city": "BREWSTER",
            "state": "OH",
            "postal_code": "446131119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 JACKSON AVE NE",
            "city": "BREWSTER",
            "state": "OH",
            "postal_code": "446131119",
            "telephone_number": "330-933-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULL",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "283635",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95318118",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "10023648",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "453333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• K C Health Services
• K-C Health Services Inc
• Jennifer Jo McDonald
• Taryn Renee Shackle
• Patrick Smith
• Vyctoria Turner
• Village of Brewster

• All providers in Brewster, OH
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.