Provider Demographics
NPI:1750794723
Name:ANDERSON, TONYA ELAINE (MSN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:ELAINE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:MRS
Other - First Name:TONYA
Other - Middle Name:BROWN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, FNP-BC
Mailing Address - Street 1:PO BOX 1237
Mailing Address - Street 2:
Mailing Address - City:CHATOM
Mailing Address - State:AL
Mailing Address - Zip Code:36518-1237
Mailing Address - Country:US
Mailing Address - Phone:251-847-6262
Mailing Address - Fax:251-847-6277
Practice Address - Street 1:14634 SAINT STEPHENS AVE
Practice Address - Street 2:
Practice Address - City:CHATOM
Practice Address - State:AL
Practice Address - Zip Code:36518-6711
Practice Address - Country:US
Practice Address - Phone:251-847-6262
Practice Address - Fax:251-847-6277
Is Sole Proprietor?:No
Enumeration Date:2014-06-08
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-083418363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily