Provider Demographics
NPI:1801837729
Name:LONG, TONIA M (CRNP)
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:M
Last Name:LONG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1110 E 6TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-3957
Mailing Address - Country:US
Mailing Address - Phone:256-397-8842
Mailing Address - Fax:256-246-9764
Practice Address - Street 1:1110 E 6TH ST
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-3956
Practice Address - Country:US
Practice Address - Phone:256-397-8842
Practice Address - Fax:833-913-2311
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1092292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-69333OtherBCBS AL
AL183740Medicaid
AL183740Medicaid
AL511-69333OtherBCBS AL
AL051559007Medicare PIN
AL10250I0844Medicare PIN