Provider Demographics
NPI:1790224970
Name:OSTMANN, TONI LEE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:TONI
Middle Name:LEE
Last Name:OSTMANN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 OAK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-6473
Mailing Address - Country:US
Mailing Address - Phone:618-670-4055
Mailing Address - Fax:
Practice Address - Street 1:17 GINGER CREEK MDWS
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034
Practice Address - Country:US
Practice Address - Phone:618-656-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041415993163W00000X
MO2012038003163W00000X
MO2017005258363LF0000X
IL209015465363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse