Provider Demographics
NPI:1770712481
Name:ATCHESON, TONI
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:ATCHESON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9862 A HWY 206 W
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-5086
Mailing Address - Country:US
Mailing Address - Phone:870-743-4877
Mailing Address - Fax:
Practice Address - Street 1:9862A HIGHWAY 206 W
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-5086
Practice Address - Country:US
Practice Address - Phone:870-743-4877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR053129930303E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide