Healthcare Provider Details

I. General information

NPI: 1629469564
Provider Name (Legal Business Name): KIMBERLY T JONES NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2015
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7460 WOLF RIVER BLVD
GERMANTOWN TN
38138-1760
US

IV. Provider business mailing address

1211 UNION AVE STE 330
MEMPHIS TN
38104-6655
US

V. Phone/Fax

Practice location:
  • Phone: 901-763-0200
  • Fax: 901-761-4002
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19672
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: