Provider Demographics
NPI:1811539299
Name:TYSON, BRITTANY ROSE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:ROSE
Last Name:TYSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 SMOKE RISE TRL
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-7805
Mailing Address - Country:US
Mailing Address - Phone:919-827-2604
Mailing Address - Fax:
Practice Address - Street 1:68 HOSPITAL RD STE 201
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-2722
Practice Address - Country:US
Practice Address - Phone:828-586-7654
Practice Address - Fax:828-586-7655
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012426363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner