MRS. JUSTINE KOERNER TYE CPNP NPI 1366724098

NPI Information

  • NPI: 1366724098
  • Provider Name: MRS. JUSTINE KOERNER TYE, CPNP
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: 1350 S KINGS DR
    CHARLOTTE, NC
    ZIP 28207
  • Phone: (704) 446-1422

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NPI Details

MRS. Justine Koerner Tye, CPNP is a pediatrics nurse practitioner in Charlotte, NC. MRS. Justine Koerner Tye, CPNP NPI is 1366724098. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1350 S KINGS DR
CHARLOTTE, NC
ZIP 28207-134
Phone: (704) 446-1422
Fax: (704) 446-1582

The enumeration date for this NPI number is 9/20/2011 and was last updated on 1/3/2014.

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
1363LP0200XNurse PractitionerPediatrics5005317NORTH CAROLINANo
2363LP0200XNurse PractitionerPediatrics160512NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1NCF532AMEDICARE PINNORTH CAROLINA
2NP2580MEDICAIDSOUTH CAROLINA
31366724098MEDICAIDNORTH CAROLINA
41558308080MEDICAIDNORTH CAROLINA

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

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