| Doctor Name: | CARRIE ELIZABETH TYNER |
| NPI Number: | 1114357613 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, FNP-C |
| License Number: | 2013034520 |
| Business Practice Address: | 19601 W 101st St Lenexa, KS - 662208600 |
| Business Phone Number: | 9132135388 |
| Business Fax Number: | 9132135752 |
| Mailing Address: | 19601 W 101st St, LENEXA |
| State: | KS |
| Postal Code: | 662208600 |
| Phone Number: | 9132135388 |
| Fax Number: | 9132135752 |
| NPI Enumeration Date: | 11/19/2013 |
| NPI Last Update Date: | 01/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2013034520 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |