Individual
TYLER BLAKE SKELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1009 NOVUS DR STE 2, JOHNSON CITY, TN 37604-8237
(423) 283-0776
(423) 283-0549
Mailing address
1009 NOVUS DR STE 2, JOHNSON CITY, TN 37604-8237
(423) 283-0776
(423) 283-0549
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201292
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN25873
TN
Other
Enumeration date
04/30/2019
Last updated
07/27/2021
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