Individual
TYLER WELLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-9060
(859) 323-5956
(859) 323-1080
Mailing address
703 S 42ND ST, MIDDLESBORO, KY 40965-9060
(606) 923-9964
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
1139550
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3018889
KY
Other
Enumeration date
09/24/2020
Last updated
01/12/2023
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