Healthcare Provider Details

I. General information

NPI: 1114353117
Provider Name (Legal Business Name): JAMIE LEANN JONES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 WALKER PLACE BLVD
COPPERAS COVE TX
76522-4025
US

IV. Provider business mailing address

207 W AVENUE E
LAMPASAS TX
76550-1820
US

V. Phone/Fax

Practice location:
  • Phone: 254-547-7777
  • Fax: 254-542-0039
Mailing address:
  • Phone: 512-556-3621
  • Fax: 512-556-6594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number664372
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP124385
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: