Bourn, Tonya K
Bourn, Tonya K is an individual health care provider with primary practice located at 12101 Woodcrest Executive Dr Ste 150 , Creve Coeur MO 63141-5050. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Bourn, Tonya K can be contacted via phone (314) 863-9966.Contact Information
Primary practice address
12101 Woodcrest Executive Dr Ste 150
Creve Coeur MO 63141-5050
Phone: (314) 863-9966
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046008999 | Illinois |
Profile Details
| NPI number | 1851340152 |
|---|---|
| LBN Legal business name | Bourn, Tonya K |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 6th, 2006 |
| Last updated | Apr 29th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851340152 | NPPES |
| Illinois | MEDICAID | 046008999 |
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