Provider Demographics
NPI:1992734032
Name:ASHLINE, TONIA R (PA-C)
Entity type:Individual
Prefix:
First Name:TONIA
Middle Name:R
Last Name:ASHLINE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TONIA
Other - Middle Name:R
Other - Last Name:GUILBAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-0043
Mailing Address - Country:US
Mailing Address - Phone:612-262-1166
Mailing Address - Fax:
Practice Address - Street 1:7450 FRANCE AVE S STE 210
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4784
Practice Address - Country:US
Practice Address - Phone:952-852-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9802363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN004932800Medicaid
MN004932800Medicaid
MN970001698Medicare ID - Type UnspecifiedMEDICARE