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General NPI Number Information
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NPI Number | 1396245056
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Entity Type | Individual
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Provider Name | ANGELA JONES FNP
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Gender | Female
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 1911 MISSION 66 STE B
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City | VICKSBURG
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State | MS
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Zip | 39180-3762
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Country | US
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Telephone | 601-456-2598
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Fax | 855-830-3484
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Provider Business Mailing Address
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Address Line | 215 KATHERINE DR
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City | FLOWOOD
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State | MS
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Zip | 39232-9588
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Country | US
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Telephone | 601-665-4162
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Fax | 888-398-1151
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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 | 902475
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License Number State | MS
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