Myra M. Tilson, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AC005810 Issued in MD

Practice address

5457 Twin Knolls Rd Ste 300
Columbia, MD 21045-3296

Phone

(410) 861-0740

Fax

(434) 225-9723

NPI assigned

Mar 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Myra M. Pierson-Brooks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1619219912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5457 TWIN KNOLLS RD STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453296",
            "telephone_number": "410-861-0740",
            "fax_number": "434-225-9723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5457 TWIN KNOLLS RD STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453296",
            "telephone_number": "410-861-0740",
            "fax_number": "434-225-9723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILSON",
        "first_name": "MYRA",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R212286",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC005810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "072673700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRA",
            "last_name": "PIERSON-BROOKS",
            "middle_name": "M.",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Columbia, MD
• Providers in Columbia, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.