Healthcare Provider Details

I. General information

NPI: 1346671229
Provider Name (Legal Business Name): TONYA M. SOMERS RD/RDN/CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TONYA M. CHAPMAN

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 03/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 E 136TH ST
FISHERS IN
46037-9417
US

IV. Provider business mailing address

250 N SHADELAND AVE STE 130 PROVIDER ENROLLMENT
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-678-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number37001695
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: