Provider Demographics
NPI:1215176912
Name:BEECH, TONYA (RN)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:BEECH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:AL
Mailing Address - Zip Code:36545-2419
Mailing Address - Country:US
Mailing Address - Phone:251-246-4025
Mailing Address - Fax:251-247-1890
Practice Address - Street 1:1506 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:AL
Practice Address - Zip Code:36545-2419
Practice Address - Country:US
Practice Address - Phone:251-246-4025
Practice Address - Fax:251-247-1890
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-062576163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse