Provider Demographics
NPI:1598350910
Name:KRIEG, TONYA L (NP)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:L
Last Name:KRIEG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:L
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-450-6815
Mailing Address - Fax:812-450-6822
Practice Address - Street 1:1808 SHERMAN DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-1043
Practice Address - Country:US
Practice Address - Phone:812-385-9420
Practice Address - Fax:812-385-9426
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28178805A363L00000X
IN71010994A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner