Healthcare Provider Details

I. General information

NPI: 1144766809
Provider Name (Legal Business Name): TEKIA LANELLE JONES PMHNP-BC, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 06/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5136 COMMUNITY CENTER DR
USAF ACADEMY CO
80840-3002
US

IV. Provider business mailing address

5136 COMMUNITY CENTER DR
USAF ACADEMY CO
80840-3002
US

V. Phone/Fax

Practice location:
  • Phone: 719-333-5177
  • Fax:
Mailing address:
  • Phone: 719-333-5177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberC-APN.0001177-C-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: