Provider Demographics
NPI:1275205643
Name:LOYD, TAWNY (PA-C)
Entity Type:Individual
Prefix:
First Name:TAWNY
Middle Name:
Last Name:LOYD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TAWNY
Other - Middle Name:
Other - Last Name:TUCCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:26075 AUDRAIN ROAD 832
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-6711
Mailing Address - Country:US
Mailing Address - Phone:630-254-4353
Mailing Address - Fax:
Practice Address - Street 1:1601 E BROADWAY STE 240
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8022
Practice Address - Country:US
Practice Address - Phone:573-815-8145
Practice Address - Fax:573-815-3832
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical