KYLE TIETZE
NPI 1699507301
Military Health Care Provider - Independent Duty Corpsman in Duluth, MN

Active since August 20, 2024
1201 MINNESOTA AVE, DULUTH, MN 55802(218) 529-3109 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Kyle Tietze NPPES

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

KYLE TIETZE (NPI 1699507301) is an individual independent duty corpsman provider in Duluth, Minnesota and active in the NPI registry since August 2024.

NPPES Registry Identity

NPI1699507301
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameKYLE TIETZE
Location Address1201 MINNESOTA AVEDuluth, MN 55802-2424
Mailing Address1201 Minnesota AveDuluth, MN 55802-2424 · (218) 529-3109
Sole ProprietorNo
Enumeration DateAugust 20, 2024
NPPES CertifiedAugust 20, 2024
NPI 1699507301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

1201 MINNESOTA AVE, Duluth, MN 55802

Other Providers at the Same Location NPPES 3

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

Technician, Other
1201 MINNESOTA AVE
DULUTH, MN 55802
Technician, Other
1201 MINNESOTA AVE, USCGC ALDER (WLB-216)
DULUTH, MN 55802
Military Health Care Provider (Independent Duty Medical Technicians)
1201 MINNESOTA AVE
DULUTH, MN 55802

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1699507301, enumerated as an "individual" on August 20, 2024.

The provider is located at 1201 MINNESOTA AVE DULUTH, MN 55802 and the phone number is (218) 529-3109.

Military Health Care Provider with taxonomy code 1710I1002X and a focus in Independent Duty Corpsman.