Leslie Polk Van Dyke in Tyler - Registered Nurse
Leslie Polk Van Dyke - NPI 1124023916
Leslie Polk Van Dyke is a Registered Nurse in Tyler, Texas. Leslie Polk Van Dyke practices all healthcare services and medical treatments related to Registered Nurse. The NPI Number for Leslie Polk Van Dyke is 1124023916. The last update date is 2021-05-07.
Leslie Polk Van Dyke's current location address is 1658 W Grande Blvd, Tyler, Texas. You can contact this provider via phone number 9036176239 and fax number 9036176249. The mailing address for Leslie Polk Van Dyke is 1658 W Grande Blvd, Tyler, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Leslie Polk Van Dyke |
|---|---|
| Address | 1658 W Grande Blvd, Tyler, Texas |
| Phone Number | 9036176239 |
| Fax Number | 9036176249 |
| Sole Proprietor | N |
| Credentials | ARNP |
NPI Number Detail
| NPI Number | 1124023916 |
|---|---|
| Provider Enumeration Date | 2005-06-17 |
| Last Updated Date | 2021-05-07 |
Provider Mailing Address Detail
| Address | 1658 W Grande Blvd |
|---|---|
| City | Tyler |
| State | Texas (TX) |
| Post Code | 7570344260 |
| Phone Number | 9036176239 |
| Fax Number | 9036176249 |
Provider's Primary Taxonomy Detail
| Speciality | Registered Nurse |
|---|---|
| Taxonomy | 163W00000X |
| Licence No | 53-45551-051 |
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Definition: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8772NA | TX | BCBS | |
| 200253540A | KS | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Leslie Polk Van Dyke by the Centers for Medicare & Medicaid Services?
The Leslie Polk Van Dyke has been assigned the NPI (National Provider Identifier) 1124023916 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Leslie Polk Van Dyke is located?
The Leslie Polk Van Dyke is situated at the following address: 1658 W Grande Blvd, Tyler, TX, 7570344260.
What is the Leslie Polk Van Dyke's specialty and taxonomy code?
The Leslie Polk Van Dyke's specialty is Registered Nurse, and the corresponding taxonomy code is 163W00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1124023916 to Leslie Polk Van Dyke?
The Centers for Medicare & Medicaid Services originally issued the 1124023916 to Leslie Polk Van Dyke on 2005-06-17.
When was the information regarding Leslie Polk Van Dyke, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Leslie Polk Van Dyke, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2021-05-07.