| Doctor Name: | JENNIFER TYLER |
| NPI Number: | 1366819930 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CDC-1, ICCTP |
| License Number: | 1023805 |
| Business Practice Address: | 10735 Kenai Spur Hwy # 2b Kenai, AK - 996117859 |
| Business Phone Number: | 9072839947 |
| Business Fax Number: | 9072839949 |
| Mailing Address: | 1700 Lawton Dr # A, KENAI |
| State: | AK |
| Postal Code: | 996118913 |
| Phone Number: | 9072839947 |
| Fax Number: | 9072839949 |
| NPI Enumeration Date: | 08/30/2015 |
| NPI Last Update Date: | 08/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 1023805 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AK |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |