Individual
ELIZABETH TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-0211
Mailing address
2615 YORK DR, AUGUSTA, GA 30909-2003
(706) 627-0602
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN235927
GA
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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