Individual provider · Type 1 NPI
Charley Tyre, NP-C
Adult Health Nurse Practitioner · Grimesland, NC
NPI number
1609204585
Active
Practice location
2627 Winding Cv
Grimesland, NC 27837-8612
Mailing address
PO Box 333
Manns Harbor, NC 27953-0333
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | 5006569 (NC) |
Adult Health Nurse Practitioner: Definition to come...
About NPI 1609204585
Charley Tyre, NP-C's National Provider Identifier is 1609204585, issued on Oct 31, 2013. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Grimesland, NC. The record was last updated on Mar 9, 2022.