Healthcare Provider Details

I. General information

NPI: 1801415609
Provider Name (Legal Business Name): PATRICE T JONES NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICE T. JONES NP

II. Dates (important events)

Enumeration Date: 04/11/2020
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 TREE LN STE 250
SNELLVILLE GA
30078-6799
US

IV. Provider business mailing address

1800 TREE LN STE 250
SNELLVILLE GA
30078-6799
US

V. Phone/Fax

Practice location:
  • Phone: 770-736-6300
  • Fax:
Mailing address:
  • Phone: 321-525-0931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN241839
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberRN241839
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberRN241839
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: