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General NPI Number Information
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NPI Number | 1134793938
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Entity Type | Individual
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Provider Name | KIPPER JONES FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 910 E HOUSTON ST STE 600
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City | TYLER
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State | TX
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Zip | 75702-8304
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Country | US
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Telephone | 903-526-2644
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Fax | 903-526-0653
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Provider Business Mailing Address
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Address Line | 629 PRESTONWOOD CIR
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City | TYLER
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State | TX
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Zip | 75703-5045
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Country | US
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Telephone | 903-392-0083
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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 | 1029238
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License Number State | TX
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