Provider Demographics
NPI:1841914595
Name:FREE, TONYA (CNA)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:FREE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 NOTRE DAME RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-1646
Mailing Address - Country:US
Mailing Address - Phone:815-997-2455
Mailing Address - Fax:
Practice Address - Street 1:1614 NOTRE DAME RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-1646
Practice Address - Country:US
Practice Address - Phone:815-997-2455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0000OtherJUST NEED NPI NUMBER
IL00000OtherJUST NEED MY NPI NUMBER PLEASE
IL00000OtherJUST NEED NPI NUMBER
IL0000OtherCNA CERTIFICATION
IL0000OtherCNA JUST LOOKING FOR MY NPI NUMBER