Tattersall, Justin Gerald

Tattersall, Justin Gerald is an individual health care provider with primary practice located at 625 E Broadway Ave , Jackson WY 83001-8642. He recently has only one registered license in Nursing Service Providers / Registered Nurse First Assistant, which is considered as his primary health care specialty. Tattersall, Justin Gerald can be contacted via phone (307) 733-3636.

Contact Information

Primary practice address
625 E Broadway Ave Jackson WY 83001-8642
Phone: (307) 733-3636
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse First Assistant 163WR0006X 30955 Wyoming

Profile Details

NPI number 1518479104
LBN Legal business name Tattersall, Justin Gerald
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2017
Last updated Nov 3rd, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518479104 NPPES
Other 3074130437 NONE

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