Tyson Ryley Nickelson Valid NPI

Individual provider · Nurse Practitioner · Manhattan, KS

NPI

1972194751

Type

Individual (Type 1)

Primary specialty

Nurse Practitioner

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363L00000X

License number

53-79960-011 (KS)

Sex

Male

Sole proprietor

No

Enumerated

2021-02-03

Last updated

2021-02-03