Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TYRAY M PETTY
ActiveTYRAY M PETTY is a Community Health Worker healthcare provider located in BOISE, Idaho. NPI 1891555025 is currently active in the NPPES registry. Verify at CMS.
Community Health Worker · BOISE, ID
Registration Details
- NPI Number
- 1891555025
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 22, 2024 (2.358077555265 yrs)
- Last Updated
- Mar 22, 2024
Practice Information
- Address
-
6305 W OVERLAND RDBOISE, ID, 837093029Browse ID providers · Browse ZIP 83709
- Phone
- 2086053663
- Primary Specialty
-
Community Health Worker
172V00000X
- Additional Specialty
- Community Health Worker
Other Community Health Worker Providers in BOISE, ID
| Name | Credential | NPI |
|---|---|---|
| KIMBERLEE BRANT | LPN LMT | 1285027672 |
| RUSSELL ADAM MONTGOMERY | BA | 1861269383 |
| TAMMIE HAYNES | BA | 1407623598 |
| MS. TAMY JO MURKLE | BA, MA | 1699535260 |
| JESLYN MASHELL NEES | BS, MA | 1922868694 |
| TYLAR KELTY | — | 1750141966 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.