Harris, Tyson A

Harris, Tyson A is an individual health care provider with primary practice located at 98 Poplar St , Blackfoot ID 83221-1758. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as his primary health care specialty. Harris, Tyson A can be contacted via phone (208) 782-3763.

Contact Information

Primary practice address
98 Poplar St Blackfoot ID 83221-1758
Phone: (208) 782-3763
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X NP-1272A Idaho
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP60641080 Washington

Profile Details

NPI number 1588905699
LBN Legal business name Harris, Tyson A
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2013
Last updated Jun 9th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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