Healthcare Provider Details

I. General information

NPI: 1457593485
Provider Name (Legal Business Name): JUDY L. JONES, FAMILY NURSE PRACTITIONER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 HIGHWAY 64 E STE 4
WAYNESBORO TN
38485-3050
US

IV. Provider business mailing address

530 HIGHWAY 64 E STE 4
WAYNESBORO TN
38485-3050
US

V. Phone/Fax

Practice location:
  • Phone: 931-722-7722
  • Fax: 931-722-7725
Mailing address:
  • Phone: 931-722-7722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JUDY LYNN JONES
Title or Position: NURSE PRACTITIONER / OWNER
Credential: APN
Phone: 931-722-7722