NPivot
Tyler Johnson is one of 209 nurse practitioners practicing in Waco, Texas .
Tyler Johnson practices with Legacy Urgent Care PA and Providence Health Alliance.
Registry record (NPPES)
NPI
1912748880
Type
Type 1 · Individual
Primary taxonomy
Nurse Practitioner, Acute Care · 363LA2100X
Address on file
6901 Medical Pkwy Waco, TX 76712-7910 (254) 751-4180
Enumerated
Jun 4, 2024
Record last updated
Jun 4, 2024
License states listed
TX
Medicare (CMS)
Enrollment
Medicare-enrolled in TXNurse Practitioner
Revalidation due
No date set by CMS
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Part D prescribing
Procedure volumes by CPT code
Group affiliations and colleagues
Full enrollment history
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Practice locations
221 S Jack Kultgen Expy Suite 200
Waco , TX 76706
(844) 813-1749
301 Richland W Cir Providence Internal Medicine Clinic
Waco , TX 76712
(254) 537-6200
7003 Woodway Dr
Waco , TX 76712
729 Sun Valley Blvd
Hewitt, TX 76643
(254) 537-6700
More nurse practitioners in Waco
Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.
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