Provider Demographics
NPI:1194743310
Name:CARTER, TONYA DANNELLE (LPN)
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:DANNELLE
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2782 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4858
Mailing Address - Country:US
Mailing Address - Phone:614-891-9554
Mailing Address - Fax:614-891-9554
Practice Address - Street 1:2782 MAPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4858
Practice Address - Country:US
Practice Address - Phone:614-891-9554
Practice Address - Fax:614-891-9554
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN090550164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse