Individual
MR. JOEL L TYSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10 SOUTH HOSPITAL DRIVE, FULTON, MO 65251
(573) 642-3376
(573) 592-6679
Mailing address
10 SOUTH HOSPITAL DRIVE, FULTON, MO 65251
(573) 642-3376
(573) 592-6679
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
078835
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN078835
MISSOURI STATE LICENSE NU
MO
Enumeration date
01/20/2006
Last updated
04/18/2008
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