Provider Demographics
NPI:1881393965
Name:WEST, TONI DEAN (LPN)
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:DEAN
Last Name:WEST
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3401 N MORRISON RD
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5568
Mailing Address - Country:US
Mailing Address - Phone:765-254-5602
Mailing Address - Fax:
Practice Address - Street 1:3401 N MORRISON RD
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5568
Practice Address - Country:US
Practice Address - Phone:765-254-5602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27054911A164W00000X
IN27054311A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty