Provider Demographics
NPI:1770052235
Name:JENNINGS, TONIKA M (CD)
Entity type:Individual
Prefix:
First Name:TONIKA
Middle Name:M
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4839 TRUITT LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-4324
Mailing Address - Country:US
Mailing Address - Phone:828-536-0728
Mailing Address - Fax:
Practice Address - Street 1:4839 TRUITT LN
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-4324
Practice Address - Country:US
Practice Address - Phone:828-536-0728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty