Provider Demographics
NPI:1295471902
Name:KINNEY, TONYA (RN CASE MANAGER)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:
Last Name:KINNEY
Suffix:
Gender:F
Credentials:RN CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4808 LAKEMONT DR SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513-4551
Mailing Address - Country:US
Mailing Address - Phone:360-402-3835
Mailing Address - Fax:
Practice Address - Street 1:9040A JACKSON AVE MAMC JBLM
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-4326
Practice Address - Fax:253-968-6026
Is Sole Proprietor?:No
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00130790163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics