Provider Demographics
NPI:1861479339
Name:TONEY, LINDA BERGMAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:BERGMAN
Last Name:TONEY
Suffix:
Gender:F
Credentials:FNP
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 SHADY LANE
Practice Address - Street 2:
Practice Address - City:WHITE STONE
Practice Address - State:VA
Practice Address - Zip Code:22578
Practice Address - Country:US
Practice Address - Phone:804-435-3133
Practice Address - Fax:804-435-1311
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024096491363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1861479339Medicaid
VA017646R53Medicare PIN
VAP00616645Medicare PIN
P42724Medicare UPIN