Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TYLER NELLIS, CPED4584
Active Sole ProprietorTYLER NELLIS, CPED4584 is a 224L00000X healthcare provider located in BRUSSELS, Wisconsin. NPI 1457172595 is currently active in the NPPES registry. Verify at CMS.
224L00000X · BRUSSELS, WI
Registration Details
- NPI Number
- 1457172595
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 22, 2024 (1.8246584317719 yrs)
- Last Updated
- Oct 22, 2024
- License
-
CPED4584 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
9810 COUNTY ROAD DBRUSSELS, WI, 542049511Browse WI providers · Browse ZIP 54204
- Phone
- 9204455515
- Primary Specialty
-
224L00000X
224L00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.