Search › North Carolina › 1041C0700X
Jaclyn Tyson
NPI 1124692629 · on the registry since 2021
Practice
- Address
- 715 W Morgan St
Raleigh, NC 27603 - Phone
- (919) 977-0087
- Clinicians at this address
- 8
Additional practice sites
- 504 Old Cypress Dr, Winston Salem, NC
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 1041C0700X
- Licence states on file
- NJ, NC
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-05-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina