Provider Demographics
NPI:1750164125
Name:TUNG, TOBEY RIGEL (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:TOBEY
Middle Name:RIGEL
Last Name:TUNG
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:TOBEY
Other - Middle Name:RIGEL
Other - Last Name:RUBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7130 WYDOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3021
Mailing Address - Country:US
Mailing Address - Phone:314-302-7868
Mailing Address - Fax:
Practice Address - Street 1:4483 DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1111
Practice Address - Country:US
Practice Address - Phone:314-454-7055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program