MRS. TYRA GODFREY
NPI 1679434377
Licensed Practical Nurse in Detroit, MI

Active since November 21, 2025
4646 JOHN R ST, DETROIT, MI 48201(313) 576-1000 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Tyra Godfrey NPPES

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

MRS. TYRA GODFREY (NPI 1679434377) is an individual licensed practical nurse in Detroit, Michigan, licensed in Michigan (4703128856) and active in the NPI registry since November 2025.

NPPES Registry Identity

NPI1679434377
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameMRS. TYRA GODFREY
Location Address4646 JOHN R STDetroit, MI 48201-1916
Mailing Address9198 Grayton StDetroit, MI 48224-1923 · (313) 421-0541
Sole ProprietorYes
Enumeration DateNovember 21, 2025
NPPES CertifiedNovember 21, 2025
NPI 1679434377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License Licensed in MI · 4703128856
Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

4646 JOHN R ST, Detroit, MI 48201

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

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Student in an Organized Health Care Education/Training Program
4646 JOHN R ST
DETROIT, MI 48201
Registered Nurse (Medical-Surgical)
4646 JOHN R ST
DETROIT, MI 48201
Registered Nurse (Gastroenterology)
4646 JOHN R ST
DETROIT, MI 48201
Registered Nurse
4646 JOHN R ST
DETROIT, MI 48201
Registered Nurse
4646 JOHN R ST
DETROIT, MI 48201
Registered Nurse
4646 JOHN R ST
DETROIT, MI 48201
Licensed Practical Nurse
4646 JOHN R ST
DETROIT, MI 48201
Religious Nonmedical Practitioner
4646 JOHN R ST
DETROIT, MI 48201

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 Tyra Godfrey's NPI number?

The NPI number for Tyra Godfrey is 1679434377. It was assigned to this individual provider in the NPPES registry on November 21, 2025.

Where is Tyra Godfrey located?

Tyra Godfrey practices at 4646 John R St, Detroit, MI 48201. The listed phone number is (313) 576-1000.

What is Tyra Godfrey's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Tyra Godfrey was last updated on November 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.