Provider Demographics
NPI:1225876758
Name:TYUS, CHARITY RENE
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:RENE
Last Name:TYUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73829 SUNNYSLOPE DR APT B
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-2345
Mailing Address - Country:US
Mailing Address - Phone:818-221-5926
Mailing Address - Fax:
Practice Address - Street 1:73829 SUNNYSLOPE DR APT B
Practice Address - Street 2:
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92277-2345
Practice Address - Country:US
Practice Address - Phone:818-221-5926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty