MS. PHYLLIS KIRBY TISDALE FNP
NPI 1235695974
Nurse Practitioner - Family in Los Angeles, CA

Q: What is Phyllis Tisdale's NPI number?

The NPI number for Phyllis Tisdale is 1235695974. It was assigned to this individual provider in the NPPES registry on February 19, 2019.

Q: What is Phyllis Tisdale's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Phyllis Tisdale was last updated on February 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 19, 2019

145 E 124TH STREET, LOS ANGELES, CA 90061(562) 221-0555(562) 595-7977 Get Directions Write a Review

NPPES record last updated: February 27, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 27, 2019, Feb 19, 2019 (2 updates tracked since 2019).

On this page

About Ms. Phyllis Kirby Tisdale Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. PHYLLIS KIRBY TISDALE FNP (NPI 1235695974) is an individual family provider in Los Angeles, California, licensed in California (95010999) and active in the NPI registry since February 2019.

NPPES Registry Identity

NPI1235695974

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMS. PHYLLIS KIRBY TISDALECredential: FNP

Location Address145 E 124TH STREETLos Angeles, CA 90061

Mailing Address145 E 124th StreetLos Angeles, CA 90061 · (562) 221-0555 · Fax (562) 595-7977

Phone(562) 221-0555

Fax(562) 595-7977

Sole ProprietorYes

Enumeration DateFebruary 19, 2019

Last NPPES UpdateFebruary 27, 20192 updates tracked since enumeration

✔ NPI 1235695974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95010999

145 E 124TH STREET, Los Angeles, CA 90061

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phyllis Tisdale's NPI number?

The NPI number for Phyllis Tisdale is 1235695974. It was assigned to this individual provider in the NPPES registry on February 19, 2019.

Where is Phyllis Tisdale located?

Phyllis Tisdale practices at 145 E 124th Street, Los Angeles, CA 90061. The listed phone number is (562) 221-0555.

What is Phyllis Tisdale's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Phyllis Tisdale was last updated on February 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.