Provider Demographics
NPI:1033459169
Name:WARD, TONYA WILLIAMSON
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:WILLIAMSON
Last Name:WARD
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 1:118 VIRGINIA DR
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-2432
Mailing Address - Country:US
Mailing Address - Phone:843-395-2088
Mailing Address - Fax:
Practice Address - Street 1:140 PARK ST
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-3124
Practice Address - Country:US
Practice Address - Phone:843-398-2355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC68169163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse