Provider Demographics
NPI:1124286950
Name:DUGGER, TONI RENEE
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:RENEE
Last Name:DUGGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 WILLIAMSBURG SQUARE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-7765
Mailing Address - Country:US
Mailing Address - Phone:423-647-6710
Mailing Address - Fax:
Practice Address - Street 1:2005 WILLIAMSBURG SQ
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-7765
Practice Address - Country:US
Practice Address - Phone:423-647-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN0000066248164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse