Tyler Russell
Tyler Russell is a Student in an Organized Health Care Education/Training Program in Shreveport, Louisiana. Practices as a sole proprietor. Registered with an NPI since 2025.
- In the registry since
- 2025
Practice location Address checks out
Shreveport, LANo coordinates on file. Search this address in Google Maps
Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1639062607 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | May 30, 2025 |
| Last updated in NPPES | May 30, 2025 |
| Certification date | May 29, 2025 |
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