Provider Demographics
NPI:1982673018
Name:FREEMAN, TONYA LYNN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:LYNN
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:L
Other - Last Name:BRASWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 11037
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32524-1037
Mailing Address - Country:US
Mailing Address - Phone:850-444-7000
Mailing Address - Fax:850-444-7497
Practice Address - Street 1:1619 CREIGHTON RD STE 1
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-7152
Practice Address - Country:US
Practice Address - Phone:850-444-4700
Practice Address - Fax:850-434-8144
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1799622363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP1799622OtherFLORIDA STATE DOH LICENSE
FL017464500Medicaid
FLE4113SMedicare PIN
FLE4113WMedicare ID - Type Unspecified
FLP06374Medicare UPIN
FLP06374Medicare UPIN