Provider Demographics
NPI:1689133571
Name:EUBANKS, TONYA CARLETTE (APRN)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:CARLETTE
Last Name:EUBANKS
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 1:363 STEWART SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-7708
Mailing Address - Country:US
Mailing Address - Phone:615-582-2564
Mailing Address - Fax:
Practice Address - Street 1:330 FRANKLIN RD STE 135-A270
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3280
Practice Address - Country:US
Practice Address - Phone:225-284-7336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily