Provider Demographics
NPI:1427743442
Name:TYSON, BRITTANY MICHELLE I
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:MICHELLE
Last Name:TYSON
Suffix:I
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 1:637 GORDON RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905-2152
Mailing Address - Country:US
Mailing Address - Phone:419-565-5035
Mailing Address - Fax:
Practice Address - Street 1:637 GORDON RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905-2152
Practice Address - Country:US
Practice Address - Phone:419-565-5035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty