Provider Demographics
NPI:1356946883
Name:MCPHERSON, TONJA MICHELE
Entity type:Individual
Prefix:
First Name:TONJA
Middle Name:MICHELE
Last Name:MCPHERSON
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 1:706 WALKER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:OH
Mailing Address - Zip Code:45613-9721
Mailing Address - Country:US
Mailing Address - Phone:614-515-9120
Mailing Address - Fax:
Practice Address - Street 1:698 WALKER RIDGE RD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:OH
Practice Address - Zip Code:45613-9721
Practice Address - Country:US
Practice Address - Phone:740-226-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant