Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tyler Pemberton, PMHNP

Individual provider Psychiatry Physician · NPI 1639902679

Tyler Pemberton, PMHNP is a Nurse Practitioner in Mesa, Arizona. Qualified in 2024, 2 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
2
Licensed in
AZ
In the registry since
2024
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

334 W 10th Pl Ste 100
Mesa, AZ 85201-3499
Phone: (602) 258-6797
Fax: (602) 254-2636
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 313307 (AZ)

Record details

NPI number1639902679
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP
Sole proprietorYes
NPI enumeratedAugust 23, 2024
Last updated in NPPESJuly 29, 2025
Certification dateJuly 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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