1750959581 NPI number — TONYA N FINNEY APRN

Table of content: TONYA N FINNEY APRN (NPI 1750959581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750959581 NPI number — TONYA N FINNEY APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINNEY
Provider First Name:
TONYA
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NORTON
Provider Other First Name:
TONYA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750959581
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4724 N DAVIS HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PENSACOLA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32503-2339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-696-4000
Provider Business Mailing Address Fax Number:
850-434-2647

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1921 E NINE MILE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENSACOLA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32514-7747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-696-4000
Provider Business Practice Location Address Fax Number:
850-434-2647
Provider Enumeration Date:
06/17/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  APRN11013742 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 111747500 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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