NPI 1376420570

Shawner Tyson, PHLEBOTOMIST

Practitioner Phlebotomy Technician Ridgeland, MS

Practice location

Address: 665 S Pear Orchard Rd, Ridgeland, MS 39157-4861
Phone: (601) 921-5081
Fax: (601) 860-9834
Mailing address: 5537 Highway 84, Prentiss, MS 39474-4482

Registered specialties

Phlebotomy Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246RP1900X Licence 063018-PWECW15312 (MS)

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Registry record

NPI: 1376420570
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Aug 2025
Record last updated: 19 Aug 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.