person
Ty Mauldin
Student in an Organized Health Care Education/Training Program in Sioux Falls, South Dakota
NPI 1134880453

Ty Mauldin is a Student in an Organized Health Care Education/Training Program based in Sioux Falls, SD. Ty Mauldin practices in Sioux Falls, SD. The NPI Number for Ty Mauldin is 1134880453 and holds a License No. GC05112013 (South Dakota).

The current practice location address for Ty Mauldin is 1316 W Wicklow Ct, Sioux Falls, SD and can be reached out via phone at 605-836-1227.

Location: 1316 W Wicklow Ct, Sioux Falls, SD, 57108-3252
person
Provider Profile Details
NPI Number
1134880453
Provider Name
Ty Mauldin
Credential
Provider Entity Type
Individual
Gender
Male
Address
1316 W Wicklow Ct, Sioux Falls, SD, 57108-3252
Phone Number
605-836-1227
Fax Number
Provider Enumeration Date
01/08/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5020425893002 01 TN SS NETWORK ALLIANCE #
96440 01 CA ACCME (ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION)
TAMGC05152013 01 NC GREENSBORO COLLEGE
institution
Provider Business Practice Location Address Details
Address
1316 W Wicklow Ct
City
State
Zip
57108-3252
Phone Number
605-836-1227
Fax Number
person
Provider Business Mailing Address Details
Address
1316 W Wicklow Ct
City
State
Zip
57108-3252
Phone Number
605-836-1227
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
(Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
GC05112013 (South Dakota)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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