Healthcare Provider Details
I. General information
NPI: 1285308239
Provider Name (Legal Business Name): CARMEN MELISSA GERARDE JONES PMHNP, APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/03/2021
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1389 VOLUNTEER PKWY
BRISTOL TN
37620-5709
US
IV. Provider business mailing address
115 W PINE ST APT 1
JOHNSON CITY TN
37604-6892
US
V. Phone/Fax
- Phone: 423-444-0848
- Fax: 423-523-0848
- Phone: 423-737-2718
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 29977 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: