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General NPI Number Information
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NPI Number | 1295133817
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Entity Type | Individual
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Provider Name | TONYA ALLEY LPN
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Gender | Female
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Dates
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Enumeration Date | 12/13/2014
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Last Update Date | 12/13/2014
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Provider Practice Location Address
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Address Line | 2060 CENTRE POINTE BLVD SUITE 3
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City | SAINT PAUL
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State | MN
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Zip | 55120-1269
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Country | US
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Telephone | 651-774-0011
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Fax |
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Provider Business Mailing Address
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Address Line | 8349 FILLMORE ST NE
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City | SPRING LAKE PARK
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State | MN
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Zip | 55432-1206
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Country | US
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Telephone | 612-669-6629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 054436-2
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License Number State | MN
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