Provider Demographics
NPI:1215241690
Name:KING, TONYA M (BA)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:M
Last Name:KING
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GENERAL ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-9407
Mailing Address - Country:US
Mailing Address - Phone:870-793-3200
Mailing Address - Fax:
Practice Address - Street 1:200 GENERAL ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-9407
Practice Address - Country:US
Practice Address - Phone:870-793-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist