NPI 1902132376 · live from the CMS NPI Registry
Benjamin Layne Eithun, CRNP
Nurse Practitioner, Pediatrics, Critical Care in Tyler, TX. National Provider Identifier 1902132376, active.
NPI record
| NPI | 1902132376 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics, Critical Care 363LP0222X |
| Practice location | 800 E Dawson St, Tyler, TX 75701 |
| Practice phone | 903-606-5956 |
| Mailing address | 937 Merri Hill Dr, Oregon, WI 53575 |
| Enumerated | October 20, 2009 |
| Last updated | October 14, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics, Critical Care primary | 363LP0222X | 1159262 (TX) |
| Nurse Practitioner | 363L00000X | 5064 (WI) |
| Nurse Practitioner, Pediatrics | 363LP0200X | C178097 (IA) |
| Nurse Practitioner, Pediatrics | 363LP0200X | RN1000896 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.