Provider Demographics
NPI:1861909764
Name:CURINGTON, TYELER TIERRA (NP)
Entity type:Individual
Prefix:MRS
First Name:TYELER
Middle Name:TIERRA
Last Name:CURINGTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 MITCHELL AVE UNIT 132
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6301
Mailing Address - Country:US
Mailing Address - Phone:714-371-5627
Mailing Address - Fax:
Practice Address - Street 1:1881 MITCHELL AVE UNIT 132
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6301
Practice Address - Country:US
Practice Address - Phone:714-371-5627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007873363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty