Wilma R Tyus, CM

Individual provider Active NPI Case Manager/Care Coordinator · Jackson, TN

NPI 1881950277 · NPPES record last updated Apr 10, 2012

Key facts

NPI
1881950277
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
32 Conrad Dr
Jackson, TN 38305-2801
Phone
(731) 541-8344
Fax
(731) 935-8327
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

32 Conrad Dr
Jackson, TN 38305-2801

Mailing address

32 Conrad Dr
Jackson, TN 38305-2801
Phone (731) 541-8344

Other providers in Jackson, TN

All providers in Jackson, TN · Case Manager/Care Coordinator in Tennessee

Sources for this page

Verify at the official NPI Registry.