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General NPI Number Information
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NPI Number | 1417509001
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Entity Type | Individual
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Provider Name | KRISTI TUCKER JONES NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 520 GA HIGHWAY 247 S STE 501
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City | BONAIRE
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State | GA
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Zip | 31005-3886
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Country | US
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Telephone | 478-352-7110
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Fax |
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Provider Business Mailing Address
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Address Line | 104 W LINDA DR
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City | COCHRAN
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State | GA
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Zip | 31014-8308
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Country | US
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Telephone | 478-278-2130
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN201961
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License Number State | GA
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