Provider Demographics
NPI:1902395205
Name:JOST, TONYA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:MARIE
Last Name:JOST
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S RIVER ST
Mailing Address - Street 2:
Mailing Address - City:CHAMBERLAIN
Mailing Address - State:SD
Mailing Address - Zip Code:57325-1524
Mailing Address - Country:US
Mailing Address - Phone:605-680-1477
Mailing Address - Fax:605-473-0607
Practice Address - Street 1:104 S RIVER ST
Practice Address - Street 2:
Practice Address - City:CHAMBERLAIN
Practice Address - State:SD
Practice Address - Zip Code:57325-1524
Practice Address - Country:US
Practice Address - Phone:605-680-1477
Practice Address - Fax:605-473-0607
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR028268163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care