Provider Demographics
NPI:1093579559
Name:MCDOWELL, TONYA NICOLE
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:NICOLE
Last Name:MCDOWELL
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 1:309 VERNON LN
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-7179
Mailing Address - Country:US
Mailing Address - Phone:980-759-4105
Mailing Address - Fax:
Practice Address - Street 1:309 VERNON LN
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-7179
Practice Address - Country:US
Practice Address - Phone:980-759-4105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health