Tonya Jenettia Balthrop, L.P.N.

Individual provider Active NPI Licensed Practical Nurse · Chester, VA

NPI 1275836397 · NPPES record last updated Feb 21, 2019

Key facts

NPI
1275836397
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
0002068793 (VA)
Practice address
4318 Old Hundred Rd Ste G
Chester, VA 23831-4231
Phone
(703) 386-0088
NPI assigned
Dec 11, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0002068793VAMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0002068793 VA Yes

Addresses

Primary practice location

4318 Old Hundred Rd Ste G
Chester, VA 23831-4231

Mailing address

4318 Old Hundred Rd Ste G
Chester, VA 23831-4231
Phone (703) 386-0088

Other practice location 1

241 Arboretum Pl
#313
Richmond, VA 23236-3485
Phone (804) 677-4426

Other providers in Chester, VA

All providers in Chester, VA · Licensed Practical Nurse in Virginia

Sources for this page

Verify at the official NPI Registry.