Healthcare Provider Details

I. General information

NPI: 1235367251
Provider Name (Legal Business Name): TONYA D MASON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TONYA D WHITFIELD NP

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 06/04/2024
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4537 S NUCOR RD
CRAWFORDSVILLE IN
47933-7969
US

IV. Provider business mailing address

4537 S NUCOR RD
CRAWFORDSVILLE IN
47933-7969
US

V. Phone/Fax

Practice location:
  • Phone: 765-362-3579
  • Fax: 877-558-9529
Mailing address:
  • Phone: 765-362-3579
  • Fax: 877-558-9529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71002953
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: