Provider Demographics
NPI:1033682521
Name:ORUM, TONI MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:MARIE
Last Name:ORUM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 N SCOTT ST STE 21
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-6363
Mailing Address - Country:US
Mailing Address - Phone:307-429-1202
Mailing Address - Fax:307-278-6353
Practice Address - Street 1:39 N SCOTT ST STE 21
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-6363
Practice Address - Country:US
Practice Address - Phone:307-429-1202
Practice Address - Fax:307-278-6353
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY28331.1852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily