Individual
TYSON RYLEY NICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 RESEARCH DR, MANHATTAN, KS 66503-3049
(785) 539-4644
Mailing address
3517 CHURCHILL WAY, MANHATTAN, KS 66503-0384
(785) 236-9632
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-79960-011
KS
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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