Provider Demographics
NPI:1093940892
Name:OCHOA, TONYA (LPN)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:OCHOA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9205 HIGHWAY 15 S
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:GA
Mailing Address - Zip Code:31035-7745
Mailing Address - Country:US
Mailing Address - Phone:478-232-4019
Mailing Address - Fax:
Practice Address - Street 1:9205 HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:GA
Practice Address - Zip Code:31035-7745
Practice Address - Country:US
Practice Address - Phone:478-232-4019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN063523164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse