Provider Demographics
NPI:1295541407
Name:MONK, TONYA
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:MONK
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 1:496 HENRY SMITH RD
Mailing Address - Street 2:
Mailing Address - City:BERNICE
Mailing Address - State:LA
Mailing Address - Zip Code:71222-5522
Mailing Address - Country:US
Mailing Address - Phone:318-608-0103
Mailing Address - Fax:
Practice Address - Street 1:1495 FRAZIER RD
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-1632
Practice Address - Country:US
Practice Address - Phone:318-202-3860
Practice Address - Fax:318-202-5953
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN105454163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult