Provider Demographics
NPI:1033681010
Name:GOBLE, TONYA (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:GOBLE
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:NEWSOME
Other - Last Name:GOBLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:63 TOMS CRK
Mailing Address - Street 2:
Mailing Address - City:IVEL
Mailing Address - State:KY
Mailing Address - Zip Code:41642-9040
Mailing Address - Country:US
Mailing Address - Phone:606-478-5170
Mailing Address - Fax:
Practice Address - Street 1:63 TOMS CRK
Practice Address - Street 2:
Practice Address - City:IVEL
Practice Address - State:KY
Practice Address - Zip Code:41642-9040
Practice Address - Country:US
Practice Address - Phone:606-478-5170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-01
Last Update Date:2019-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012914363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily