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Individual
TIFFANY DESHELIA TYSON
Active
Individual
TIFFANY DESHELIA TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C, PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
179114
NC
363LF0000X
Family Nurse Practitioner
Primary
5004707
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5004707
NC
Other
Enumeration date
04/20/2010
Last updated
04/14/2022
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