Provider Demographics
NPI:1013306547
Name:TYUS, BRITTNEY (NP-C)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:TYUS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:
Other - Last Name:LONDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:721 E SHOTWELL ST
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-4063
Mailing Address - Country:US
Mailing Address - Phone:229-400-9260
Mailing Address - Fax:
Practice Address - Street 1:721 E SHOTWELL ST
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-4063
Practice Address - Country:US
Practice Address - Phone:229-400-9260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN210080363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003157590BMedicaid