Provider Demographics
NPI:1003059072
Name:JOHNSON, TONYA TRESSA (ANP)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:TRESSA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MS
Other - First Name:TONYA
Other - Middle Name:TRESSA
Other - Last Name:DENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:1844 CROSSWICK CT
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-8193
Mailing Address - Country:US
Mailing Address - Phone:678-469-7935
Mailing Address - Fax:
Practice Address - Street 1:1844 CROSSWICK CT
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-8193
Practice Address - Country:US
Practice Address - Phone:678-469-7935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024139363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty