Provider Demographics
NPI:1649927807
Name:TYSON, ASHLEIGH (MS, RD, CSO, LDN)
Entity type:Individual
Prefix:MRS
First Name:ASHLEIGH
Middle Name:
Last Name:TYSON
Suffix:
Gender:F
Credentials:MS, RD, CSO, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 HEALTH DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-4370
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 HEALTH DR
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4370
Practice Address - Country:US
Practice Address - Phone:252-634-6514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, OncologyGroup - Single Specialty