Provider Demographics
NPI:1427555622
Name:SPIVEY, TONNIE CROWLEY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:TONNIE
Middle Name:CROWLEY
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 PEACHTREE DR
Mailing Address - Street 2:
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-5810
Mailing Address - Country:US
Mailing Address - Phone:843-910-0595
Mailing Address - Fax:
Practice Address - Street 1:132 PEACHTREE DR
Practice Address - Street 2:
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-5810
Practice Address - Country:US
Practice Address - Phone:843-910-0595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF04180156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily