Basic Information
| Provider Information | |||||||||
| NPI: | 1922307206 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TONEY | ||||||||
| FirstName: | TERRY | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 472 RANKIN DR | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287526568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286521400 | ||||||||
| FaxNumber: | 8286597829 | ||||||||
| Practice Location | |||||||||
| Address1: | 472 RANKIN DR | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287526568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286521400 | ||||||||
| FaxNumber: | 8286597829 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2011 | ||||||||
| LastUpdateDate: | 03/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 5005099 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 158625 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | 5005099 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 7004962 | 05 | NC | MEDICAID | NP1829 | 05 | SC | MEDICAID | NC2361A | 01 | NC | MEDICARE PTAN | OTHER | 1922307206 | 05 | NC | MEDICAID |