Provider Demographics
NPI:1013543362
Name:WARREN, TONYA (RN)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:694 N BEND RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-7577
Mailing Address - Country:US
Mailing Address - Phone:859-992-8203
Mailing Address - Fax:
Practice Address - Street 1:694 N BEND RD
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-7577
Practice Address - Country:US
Practice Address - Phone:859-992-8203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1157730163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)