Mrs. Justine Koerner Tye
CPNP | Nurse Practitioner - Pediatrics
1350 S Kings Dr, Charlotte
North Carolina, 28207-2134
704-446-1422
Mrs. Justine Koerner Tye is a Charlotte, North Carolina based nurse practitioner who is specialized as Pediatrics nurse. Active license number of Mrs. Justine Koerner Tye is 160512 for Pediatrics in North Carolina. Her current practice location is 1350 S Kings Dr, Charlotte. Patients can reach her at 704-446-1422 or can fax her at 704-446-1582. Mrs. Justine Koerner Tye is CPNP with specialization in Pediatrics and her NPI number (Unique professional ID assigned by NPPES) is 1366724098.
Mrs. Justine Koerner Tye specializes in caring for newborns, infants, toddlers, adolescents and young adults. She perform pediatric health care maintenance, including well child exams, developmental screenings and in-depth physical assessments, such as vision, hearing and dental. Pediatrics Nurse Practitioner (PNP) focus on well-child care and the prevention or management of common pediatric acute illnesses and chronic conditions.
Complete Profile:
Mrs. Justine Koerner Tye speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Mrs. Justine Koerner Tye |
| Specialization: | Pediatrics Nurse Practitioner (PNP) |
| Gender: | Female |
| Credentials: | CPNP |
| Practice Address: | 1350 S Kings Dr, Charlotte,
North Carolina, 28207-2134 |
| Phone: | 704-446-1422 |
| Fax: | 704-446-1582 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1366724098 |
| NPI Enumeration Date: | 20 Sep, 2011 |
| NPI Last Update On: | 03 Jan, 2014 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mrs. Justine Koerner Tye are as mentioned below.
| License Number | Specialization | State | Status | |
| 160512 | Pediatrics | North Carolina | Primary | |
| 5005317 | Pediatrics | North Carolina | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Mrs. Justine Koerner Tye such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1366724098 | Medicaid | North Carolina | |
| NP2580 | Medicaid | South Carolina | |
| 1558308080 | Medicaid | North Carolina | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Mrs. Justine Koerner Tye
Po Box 601372,
Charlotte, North Carolina |
| Zip: | 28260-1372 |
| Phone Number: | 704-446-1422 |
| Fax Number: | 704-446-1582 |
Patients can reach Mrs. Justine Koerner Tye at
1350 S Kings Dr, Charlotte, North Carolina or can
call to book an appointment on 704-446-1422.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.