Provider Demographics
NPI:1205966710
Name:ESTEP-HUDSON, TONYA DAWN (CPHT)
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:DAWN
Last Name:ESTEP-HUDSON
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 PINEY GREEN ROAD
Mailing Address - Street 2:
Mailing Address - City:CREWE
Mailing Address - State:VA
Mailing Address - Zip Code:23930
Mailing Address - Country:US
Mailing Address - Phone:434-292-3331
Mailing Address - Fax:
Practice Address - Street 1:5001 E. PATRICK HENRY HWY.
Practice Address - Street 2:
Practice Address - City:BURKEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23922
Practice Address - Country:US
Practice Address - Phone:434-767-4401
Practice Address - Fax:434-767-4935
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician