Individual
ALISHA TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
511 MAIN ST APT G13, WEST HAVEN, CT 06516-4260
(203) 707-4612
Mailing address
PO BOX 4043, HAMDEN, CT 06514-0043
(203) 707-4612
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12946
CT
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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