NPI 1114379690

Tyler Marshall, CRNA

Practitioner Certified Registered Nurse Anesthetist Farmington, NM

Practice location

Address: 801 W Maple St, Farmington, NM 87401-5630
Phone: (505) 609-6648
Fax: (505) 609-2259
Mailing address: 2204 Ironwood Pl STE B, Coeur D Alene, ID 83814-2662

Registered specialties

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence CRNA-01419 (NM)

Other Nurse Anesthetist, Certified Registered providers in New Mexico →

Registry record

NPI: 1114379690
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Jul 2016
Record last updated: 30 Aug 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.