Provider Demographics
NPI:1942532163
Name:CHRISTIAN, TONIA GALE (PMHNP)
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:GALE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 DECHERD BLVD
Mailing Address - Street 2:
Mailing Address - City:DECHERD
Mailing Address - State:TN
Mailing Address - Zip Code:37324-3655
Mailing Address - Country:US
Mailing Address - Phone:931-967-6669
Mailing Address - Fax:
Practice Address - Street 1:482 INTERSTATE DR STE D
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-3409
Practice Address - Country:US
Practice Address - Phone:931-444-1000
Practice Address - Fax:931-729-1229
Is Sole Proprietor?:No
Enumeration Date:2010-02-13
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14496363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN264000355OtherBLUE CROSS BLUE SHIELD OF TENNESSEE
TN264000355Medicaid
TN264000355Medicaid
TN264000355Medicare Oscar/Certification
TN264000355OtherBLUE CROSS BLUE SHIELD OF TENNESSEE