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General NPI Number Information
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NPI Number | 1730669086
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Entity Type | Individual
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Provider Name | TYLON STAGGS RN
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Gender | Female
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 1034 GLENDALE AVE # A
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City | WHEELERSBURG
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State | OH
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Zip | 45694-9381
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Country | US
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Telephone | 730-307-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 1034 GLENDALE AVE # A
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City | WHEELERSBURG
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State | OH
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Zip | 45694-9381
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 119926
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0036302
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License Number State | OH
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