Tyre, Mitzi Braddock

Tyre, Mitzi Braddock is an sole proprietor health care provider with primary practice located at 1007 Mary St , Waycross GA 31503-3823. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Tyre, Mitzi Braddock can be contacted via phone (912) 449-7100.

Contact Information

Primary practice address
1007 Mary St Waycross GA 31503-3823
Phone: (912) 449-7100
Fax: (912) 449-7080
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN170702 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN170702 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X RN170702 Georgia

Profile Details

NPI number 1396983227
LBN Legal business name Tyre, Mitzi Braddock
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2009
Last updated Mar 19th, 2024 - about 8 months 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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