Tonya Renee Bridges
Individual provider Active NPI Peer Specialist · Kennett, MO
NPI 1053964478 · NPPES record last updated Jul 24, 2019
Key facts
- NPI
- 1053964478
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 925 Highway VV
Kennett, MO 63857 - Phone
- (573) 888-5925
- NPI assigned
- Jul 24, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
925 Highway VV
Kennett, MO 63857
Mailing address
925 Highway VV
Kennett, MO 63857
Other providers in Kennett, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.