Provider Demographics
NPI:1598990863
Name:SCHIPULL, TONIA (RN WHNP BC)
Entity Type:Individual
Prefix:MRS
First Name:TONIA
Middle Name:
Last Name:SCHIPULL
Suffix:
Gender:F
Credentials:RN WHNP BC
Other - Prefix:MS
Other - First Name:TONIA
Other - Middle Name:
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN WHNP BC
Mailing Address - Street 1:1322 N 36TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2365
Mailing Address - Country:US
Mailing Address - Phone:816-364-1944
Mailing Address - Fax:816-236-2449
Practice Address - Street 1:1322 N 36TH ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2365
Practice Address - Country:US
Practice Address - Phone:816-364-1944
Practice Address - Fax:816-236-2449
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO071751363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health