Provider Demographics
NPI:1033437843
Name:MEDFORD, TONYA WARD (RN)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:WARD
Last Name:MEDFORD
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 1:275 TATE RD
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-8813
Mailing Address - Country:US
Mailing Address - Phone:731-286-3578
Mailing Address - Fax:
Practice Address - Street 1:500 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-4583
Practice Address - Country:US
Practice Address - Phone:731-635-4661
Practice Address - Fax:731-635-3630
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN169503163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health