Individual
MS. JESSIE MICHELLE TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
35 WOODFIN ST, ASHEVILLE, NC 28801-3020
(828) 250-5000
(828) 250-6165
Mailing address
112 JOHNSON ST, CANTON, NC 28716-4822
(828) 778-2048
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
146666
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146666
R.N. LICENSE NUMBER
NC
Enumeration date
11/15/2006
Last updated
07/08/2007
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