Provider Demographics
NPI:1710230446
Name:ENGLE, TONNI CHANTEL (RN)
Entity Type:Individual
Prefix:MISS
First Name:TONNI
Middle Name:CHANTEL
Last Name:ENGLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 6TH AVE
Mailing Address - Street 2:APT A9
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960
Mailing Address - Country:US
Mailing Address - Phone:641-799-9842
Mailing Address - Fax:
Practice Address - Street 1:4500 WEST MIDWAY RD
Practice Address - Street 2:
Practice Address - City:FT. PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34981
Practice Address - Country:US
Practice Address - Phone:772-468-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9347521163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent