Provider Demographics
NPI:1134228216
Name:JOACHIMSEN, TONYA K (NP-C)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:K
Last Name:JOACHIMSEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 937
Mailing Address - Street 2:
Mailing Address - City:HARTINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68739-0937
Mailing Address - Country:US
Mailing Address - Phone:402-254-3935
Mailing Address - Fax:402-254-2393
Practice Address - Street 1:405 W DARLENE ST
Practice Address - Street 2:
Practice Address - City:HARTINGTON
Practice Address - State:NE
Practice Address - Zip Code:68739-4806
Practice Address - Country:US
Practice Address - Phone:402-254-3935
Practice Address - Fax:402-254-2393
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110816363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE57300OtherREGISTERED NURSE
NE110816OtherAPRN LICENSE
NE110816OtherAPRN LICENSE