Tyson, Teresa

Tyson, Teresa is an individual health care provider with primary practice located at 208 Front St W , Coeburn VA 24230-3502. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Tyson, Teresa can be contacted via phone (276) 455-5556.

Contact Information

Primary practice address
208 Front St W Coeburn VA 24230-3502
Phone: (276) 455-5556
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024119161 Virginia

Profile Details

NPI number 1013011337
LBN Legal business name Tyson, Teresa
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2006
Last updated Mar 20th, 2019 - about 6 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 1013011337 NPPES
Virginia MEDICAID 01059873

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