Provider Demographics
NPI:1346533460
Name:BLOW, TONICA NICOLE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:TONICA
Middle Name:NICOLE
Last Name:BLOW
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 1:2010 ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-4907
Mailing Address - Country:US
Mailing Address - Phone:804-385-3797
Mailing Address - Fax:
Practice Address - Street 1:2010 ROSE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-4907
Practice Address - Country:US
Practice Address - Phone:804-385-3797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002069999164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse