Provider Demographics
NPI:1841639481
Name:YOUNGER, TONI L
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:L
Last Name:YOUNGER
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 1:1005 FAUTEUX ST
Mailing Address - Street 2:
Mailing Address - City:ELLIS
Mailing Address - State:KS
Mailing Address - Zip Code:67637-1551
Mailing Address - Country:US
Mailing Address - Phone:785-650-7740
Mailing Address - Fax:785-625-5759
Practice Address - Street 1:207 E 7TH ST # B
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-4133
Practice Address - Country:US
Practice Address - Phone:888-878-6881
Practice Address - Fax:785-625-5759
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSF0613515363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care