Individual
JERRY VINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 531-4522
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 606-6400
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
642210
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
642210
RN LICENSE
TX
Enumeration date
11/15/2006
Last updated
03/15/2023
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