Provider Demographics
NPI:1437782091
Name:EDWARDS-WRIGHT, TONYA S
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:S
Last Name:EDWARDS-WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4327 ONEGA CIR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-7870
Mailing Address - Country:US
Mailing Address - Phone:561-692-1064
Mailing Address - Fax:
Practice Address - Street 1:4327 ONEGA CIR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-7870
Practice Address - Country:US
Practice Address - Phone:561-692-1064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171241877372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion