Provider Demographics
NPI:1013255298
Name:ALLEN, TONYA RENEA (APRN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:RENEA
Last Name:ALLEN
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:MRS
Other - First Name:TONYA
Other - Middle Name:RENEA
Other - Last Name:CAPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4815 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3866
Mailing Address - Country:US
Mailing Address - Phone:501-661-2000
Mailing Address - Fax:
Practice Address - Street 1:3112 S 70TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5068
Practice Address - Country:US
Practice Address - Phone:479-452-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003803363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily