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General NPI Number Information
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NPI Number | 1104650845
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Entity Type | Individual
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Provider Name | MONA MARJORIE JEMISON FNP, ENP
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Gender | Female
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Dates
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Enumeration Date | 08/27/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 500 N HIGHLAND AVE
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City | SHERMAN
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State | TX
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Zip | 75092-7354
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Country | US
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Telephone | 903-870-4611
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Fax |
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Provider Business Mailing Address
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Address Line | 2624 COUNTY ROAD 156
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City | WHITESBORO
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State | TX
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Zip | 76273-6111
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Country | US
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Telephone | 903-267-6332
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1169647
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License Number State | TX
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