Provider Demographics
NPI:1821379561
Name:BRENT, TONI L (FPMHNP)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:L
Last Name:BRENT
Suffix:
Gender:F
Credentials:FPMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9627 WAR PARTY TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2666
Mailing Address - Country:US
Mailing Address - Phone:210-313-7547
Mailing Address - Fax:
Practice Address - Street 1:4020 FOLKER ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5386
Practice Address - Country:US
Practice Address - Phone:907-261-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX537097363LP0808X
TXAP121457363LP0808X
AK203904363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP121457OtherTEXAS BON
AK203904OtherALASKA BOARD OF NURSING