Provider Demographics
NPI:1982053724
Name:TIPTON, TONI (CNM)
Entity Type:Individual
Prefix:MRS
First Name:TONI
Middle Name:
Last Name:TIPTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:TONI
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:1 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2722
Mailing Address - Country:US
Mailing Address - Phone:937-208-2007
Mailing Address - Fax:937-208-2752
Practice Address - Street 1:2261 PHILADELPHIA DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1814
Practice Address - Country:US
Practice Address - Phone:937-276-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH19176367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife