| Ms Christina Daniels Tyler, NPC | |
|
3755 Sixes Rd, Suite 100, Canton, GA 30114 | |
| (770) 704-4580 | |
| (770) 704-9142 |
| Full Name | Ms Christina Daniels Tyler |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 3755 Sixes Rd, Canton, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871666404 | NPI | - | NPPES |
| 212738189A | Medicaid | GA | |
| 153645 | Other | GA | LIC NUMBER |
| 1952395097 | Other | GA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | RN153645NP (Georgia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | RN153645NP (Georgia) | Primary |
| Entity Name | Minuteclinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134191836 PECOS PAC ID: 6709850241 Enrollment ID: O20051024000186 |
| Entity Name | Transitional Care Physicians Of Georgia Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619317542 PECOS PAC ID: 4486895083 Enrollment ID: O20130724000471 |
| Entity Name | Chronic Disease Management Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699300939 PECOS PAC ID: 7618306721 Enrollment ID: O20200409003695 |
| Entity Name | Hardy Renew Wellness,llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952914368 PECOS PAC ID: 2961812425 Enrollment ID: O20201112000534 |
| Entity Name | Georgia Mso Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952196164 PECOS PAC ID: 3173041639 Enrollment ID: O20250519001080 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Christina Daniels Tyler, NPC 3755 Sixes Rd, Suite 100, Canton, GA 30114-7842 Ph: (770) 704-4580 | Ms Christina Daniels Tyler, NPC 3755 Sixes Rd, Suite 100, Canton, GA 30114 Ph: (770) 704-4580 |