Provider Demographics
NPI:1821324047
Name:COTTON, TONYA ANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:ANN
Last Name:COTTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1389 SAFFRON DR
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44287-9634
Mailing Address - Country:US
Mailing Address - Phone:419-945-1318
Mailing Address - Fax:419-945-1318
Practice Address - Street 1:1389 SAFFRON DR
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:OH
Practice Address - Zip Code:44287-9634
Practice Address - Country:US
Practice Address - Phone:419-945-1318
Practice Address - Fax:419-945-1318
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.N. 114132164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse