Provider Demographics
NPI:1821268137
Name:HARPER, TONYA JO (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:JO
Last Name:HARPER
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:PO BOX 21890
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4115
Mailing Address - Country:US
Mailing Address - Phone:502-907-0356
Mailing Address - Fax:502-919-9780
Practice Address - Street 1:520 S 7TH ST # 159
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1038
Practice Address - Country:US
Practice Address - Phone:812-316-0327
Practice Address - Fax:812-476-7117
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012887363LF0000X
IN71002610A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1529945OtherWELLCARE OF KY PROVIDER ID NUMBER
KY339854KYIPOtherAETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
KY7100408580Medicaid
000001096930OtherANTHEM ID
IN200898870Medicaid
CS1805300377OtherCARESOURE ID
9110204OtherAETNA PIN
2920654OtherUNITED HEALTHCARE PROVIDER ID NUMBER