Provider Demographics
NPI:1720753296
Name:BRENTLINGER, TONYA RENEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:RENEE
Last Name:BRENTLINGER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:RENEE
Other - Last Name:WETMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1711 N 6TH 1/2 ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-2700
Mailing Address - Country:US
Mailing Address - Phone:812-242-3610
Mailing Address - Fax:
Practice Address - Street 1:1711 N 6TH 1/2 ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-2700
Practice Address - Country:US
Practice Address - Phone:812-242-3610
Practice Address - Fax:812-242-3610
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011451A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily