MS. PHYLLIS KIRBY TISDALE FNP NPI 1235695974

NPI Information

NPI: 1235695974
Provider Name: MS. PHYLLIS KIRBY TISDALE, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
145 E 124TH STREET
LOS ANGELES, CA
ZIP 90061
Phone: (562) 221-0555
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MS. Phyllis Kirby Tisdale, FNP is a family nurse practitioner in Los Angeles, CA. MS. Phyllis Kirby Tisdale, FNP NPI is 1235695974. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

145 E 124TH STREET
LOS ANGELES, CA
ZIP 90061
Phone: (562) 221-0555
Fax: (562) 595-7977

The enumeration date for this NPI number is 2/19/2019 and was last updated on 2/27/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	95010999	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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