Individual
DR. TYLER TRENTON WANSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, PMHNP-BC
Contact information
Practice address
23515 US-190, MANDEVILLE, LA 70448
(985) 626-6300
Mailing address
23515 HIGHWAY 190, MANDEVILLE, LA 70448-7334
(985) 626-6300
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
211117
LA
Other
Enumeration date
02/18/2020
Last updated
04/29/2020
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