Individual provider · Type 1 NPI
Phyllis Kirby Tisdale, FNP
Family Nurse Practitioner · Los Angeles, CA
NPI number
1235695974
Active
Practice location
145 E 124th Street
Los Angeles, CA 90061
Fax (562) 595-7977
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 95010999 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1235695974
Phyllis Kirby Tisdale, FNP's National Provider Identifier is 1235695974, issued on Feb 19, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Los Angeles, CA. The record was last updated on Feb 27, 2019.