MS. PHYLLIS KIRBY TISDALE FNP NPI 1235695974

NPI Information

  • NPI: 1235695974
  • Provider Name: MS. PHYLLIS KIRBY TISDALE, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 145 E 124TH STREET
    LOS ANGELES, CA
    ZIP 90061
  • Phone: (562) 221-0555

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NPI Details

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
1363LF0000XNurse PractitionerFamily95010999CALIFORNIAYes

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: 3/30/2025

NPI Synchronization or Removal

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