Provider Demographics
NPI:1902084627
Name:KING, TONIA DENISE (RN)
Entity Type:Individual
Prefix:MS
First Name:TONIA
Middle Name:DENISE
Last Name:KING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4088 PINEORCHARD PL
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1454
Mailing Address - Country:US
Mailing Address - Phone:615-641-5221
Mailing Address - Fax:
Practice Address - Street 1:4088 PINEORCHARD PL
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-1454
Practice Address - Country:US
Practice Address - Phone:615-641-5221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN091665163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management