Provider Demographics
NPI:1811536931
Name:MCBRIDE, TONYA ARYET (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:ARYET
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2043
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71613-2043
Mailing Address - Country:US
Mailing Address - Phone:870-489-9111
Mailing Address - Fax:
Practice Address - Street 1:407 S GOULD AVE
Practice Address - Street 2:
Practice Address - City:GOULD
Practice Address - State:AR
Practice Address - Zip Code:71643-5041
Practice Address - Country:US
Practice Address - Phone:870-382-4878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR123342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily