Individual provider Active NPI

Krystala Monet Tyson, RN

  • Registered Nurse
  • Garland, TX
National Provider Identifier
1700415197
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
893984 Issued in TX
Practice address
6345 Duck Creek Dr Apt 2447
Garland, TX 75043-3665
Phone
(214) 476-3130
NPI assigned
Apr 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163W00000X 893984 TX Primary

Addresses

Primary practice location

6345 Duck Creek Dr Apt 2447
Garland, TX 75043-3665

Mailing address

6345 Duck Creek Dr Apt 2447
Garland, TX 75043-3665
Phone (214) 476-3130

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
893984TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1700415197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6345 DUCK CREEK DR APT 2447",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750433665",
            "telephone_number": "214-476-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6345 DUCK CREEK DR APT 2447",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750433665",
            "telephone_number": "214-476-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "KRYSTALA",
        "middle_name": "MONET",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "893984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.