Doctor Name: | YVONNE TYSON |
NPI Number: | 1013353143 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | ARNP9269854 |
Business Practice Address: | 1635 Eagle Harbor Pkwy Ste 1 Fleming Island, FL - 320034827 |
Business Phone Number: | 9042155262 |
Business Fax Number: | |
Mailing Address: | 1635 Eagle Harbor Pkwy Ste 1, FLEMING ISLAND |
State: | FL |
Postal Code: | 320034827 |
Phone Number: | 9042155262 |
Fax Number: | |
NPI Enumeration Date: | 05/15/2013 |
NPI Last Update Date: | 05/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP9269854 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |