Healthcare Provider Details

I. General information

NPI: 1710568407
Provider Name (Legal Business Name): ERIN JONES FNP/PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 S ALMA SCHOOL RD STE 212
MESA AZ
85210-2087
US

IV. Provider business mailing address

1220 S ALMA SCHOOL RD STE 212
MESA AZ
85210-2087
US

V. Phone/Fax

Practice location:
  • Phone: 480-808-5598
  • Fax: 480-900-8654
Mailing address:
  • Phone: 480-808-5598
  • Fax: 480-900-8654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number256282
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number256282
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: