Provider Demographics
NPI:1689293573
Name:CUMMINGS, TONYA NICOLE (NUTRITIONIST)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:NICOLE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 PROVIDENCE ST
Mailing Address - Street 2:APT. 101
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-8303
Mailing Address - Country:US
Mailing Address - Phone:571-469-2164
Mailing Address - Fax:
Practice Address - Street 1:1101 PROVIDENCE ST
Practice Address - Street 2:APT. 101
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-8303
Practice Address - Country:US
Practice Address - Phone:571-469-2164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-11
Last Update Date:2020-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist