Tyson, Stephanie E.

Tyson, Stephanie E. is an individual health care provider with primary practice located at 134 Mountainside Village Pkwy Ste 100 , Jasper GA 30143-8694. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Tyson, Stephanie E. can be contacted via phone (706) 253-3100.

Contact Information

Primary practice address
134 Mountainside Village Pkwy Ste 100 Jasper GA 30143-8694
Phone: (706) 253-3100
Fax: (706) 253-3101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN200512 Georgia

Profile Details

NPI number 1437683224
LBN Legal business name Tyson, Stephanie E.
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2017
Last updated Sep 1st, 2020 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1437683224 NPPES
Georgia MEDICAID 003203586A
Georgia Other G04354A

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