1538913561 NPI number — MRS. ANGELA KAYE TYREE RN, BSN, CPN

Table of content: MRS. ANGELA KAYE TYREE RN, BSN, CPN (NPI 1538913561)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538913561 NPI number — MRS. ANGELA KAYE TYREE RN, BSN, CPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TYREE
Provider First Name:
ANGELA
Provider Middle Name:
KAYE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, BSN, CPN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TYREE
Provider Other First Name:
ANGELA
Provider Other Middle Name:
KAYE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, BSN, CPN
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1538913561
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
109 FRENCH LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMHERST
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24521-4763
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-713-0861
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2137 LAKESIDE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNCHBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24501-6806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-404-7200
Provider Business Practice Location Address Fax Number:
434-385-8616
Provider Enumeration Date:
04/16/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WP0200X , with the licence number:  0001265073 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com