Provider Demographics
NPI:1831963230
Name:DRUM, TONI NICOLE
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:NICOLE
Last Name:DRUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:NICOLE
Other - Last Name:MEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:15565 CO RD 65
Mailing Address - Street 2:
Mailing Address - City:LONG PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56347
Mailing Address - Country:US
Mailing Address - Phone:320-808-3974
Mailing Address - Fax:
Practice Address - Street 1:50 CENTRACARE DR
Practice Address - Street 2:
Practice Address - City:LONG PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56347-2100
Practice Address - Country:US
Practice Address - Phone:320-732-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10969363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily