Provider Demographics
NPI:1972636686
Name:LINTHACUM, TONYA A (APRN,BC,FNP)
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:A
Last Name:LINTHACUM
Suffix:
Gender:F
Credentials:APRN,BC,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 WAR ADMIRAL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-4857
Mailing Address - Country:US
Mailing Address - Phone:573-875-5115
Mailing Address - Fax:
Practice Address - Street 1:1701 E BROADWAY STE 302
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8018
Practice Address - Country:US
Practice Address - Phone:573-815-8277
Practice Address - Fax:573-815-8278
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO128494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO128494OtherRN LISCENSE