Stevens, Tyler Allen

Stevens, Tyler Allen is an individual health care provider with primary practice located at 201 1St Street South , Nampa ID 83651. He recently has only one registered license in Pharmacy Service Providers / Ambulatory Care, which is considered as his primary health care specialty. Stevens, Tyler Allen can be contacted via phone (208) 466-7869.

Contact Information

Primary practice address
201 1St Street South Nampa ID 83651
Phone: (208) 466-7869
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Ambulatory Care 1835P2201X P9462 Idaho

Profile Details

NPI number 1497415244
LBN Legal business name Stevens, Tyler Allen
Credentials PHARMD
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2021
Last updated Dec 21st, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497415244 NPPES
Idaho MEDICAID P9462

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