Individual
MS. SAMANTHA TYSON
Active
Individual
MS. SAMANTHA TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041480604
IL
163W00000X
Registered Nurse
RN753326
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN10012011
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/10/2022
Last updated
03/10/2025
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