Provider Demographics
NPI:1669401071
Name:ROSS, TONI M (NP)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:M
Last Name:ROSS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:DOHERTY
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:7229 FOREST AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3765
Mailing Address - Country:US
Mailing Address - Phone:804-281-0271
Mailing Address - Fax:804-521-9367
Practice Address - Street 1:8580 MAGELLAN PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1149
Practice Address - Country:US
Practice Address - Phone:804-627-5360
Practice Address - Fax:804-627-5370
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166872363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health