Basic Information
| Provider Information | |||||||||
| NPI: | 1841639481 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YOUNGER | ||||||||
| FirstName: | TONI | ||||||||
| MiddleName: | L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1005 FAUTEUX ST | ||||||||
| Address2: | |||||||||
| City: | ELLIS | ||||||||
| State: | KS | ||||||||
| PostalCode: | 676371551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7856507740 | ||||||||
| FaxNumber: | 7856255759 | ||||||||
| Practice Location | |||||||||
| Address1: | 207 E 7TH ST # B | ||||||||
| Address2: | |||||||||
| City: | HAYS | ||||||||
| State: | KS | ||||||||
| PostalCode: | 676014133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888786881 | ||||||||
| FaxNumber: | 7856255759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2013 | ||||||||
| LastUpdateDate: | 06/17/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | F0613515 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.