Individual
HEATHER M TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1839 CENTRAL AVE, ST PETERSBURG, FL 33713-8900
(727) 322-1054
(727) 821-7213
Mailing address
1839 CENTRAL AVE, ST PETERSBURG, FL 33713-8900
(727) 322-1054
(727) 821-7213
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11014166
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112545000
—
FL
Enumeration date
07/12/2021
Last updated
12/31/2023
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