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General NPI Number Information
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NPI Number | 1588022313
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Entity Type | Individual
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Provider Name | DION GLENN TOMER RN, FNP
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Gender | Male
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 1755 N MECKLENBURG AVE
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City | SOUTH HILL
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State | VA
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Zip | 23970-4080
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Country | US
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Telephone | 434-447-3151
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Fax | 434-584-5023
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Provider Business Mailing Address
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Address Line | PO BOX 35
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City | BLACKSTONE
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State | VA
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Zip | 23824-0035
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024173265
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License Number State | VA
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