Provider Demographics
NPI:1598234635
Name:KYSER, TONJA CHERENE (LVN)
Entity Type:Individual
Prefix:
First Name:TONJA
Middle Name:CHERENE
Last Name:KYSER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16545 COUNTY ROAD 3302
Mailing Address - Street 2:
Mailing Address - City:BROWNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75756-3543
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16545 CR 3302
Practice Address - Street 2:
Practice Address - City:BROWNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75756
Practice Address - Country:US
Practice Address - Phone:214-356-0295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX135274164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse