| Provider / Organization | NPI | Date Certified |
|---|---|---|
| TYLER GREGORY ROSE | 1386213916 | 2021-07-12 |
Tyler Gregory Rose is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1386213916. Registration indicates Tyler Gregory Rose is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant: Medical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Medical, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, ) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Tyler Gregory Rose PA-C |
| Practice Office Address | 825 CHALKSTONE AVE PROVIDENCE, RI US |
| Practice Office Telephone | 4014562121 |
| Mailing Address | 459 EAST AVE # 3F PAWTUCKET, RI 028607606 US |
| Business Telephone | 8605756412 |
| Code | Practice | License No State |
|---|---|---|
| 363AM0700X | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Medical All Other Specialties & Provider Types Physician Assistant Medical Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | |
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | PA01345
RI |