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General NPI Number Information
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NPI Number | 1417833815
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Entity Type | Individual
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Provider Name | TAMMY LEE JONES PMHNP
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Gender | Female
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 1610 BLACKISTON VIEW DR
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City | CLARKSVILLE
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State | IN
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Zip | 47129-2013
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Country | US
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Telephone | 812-736-3076
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Fax |
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Provider Business Mailing Address
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Address Line | 13969 DEERFIELD XING
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City | MEMPHIS
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State | IN
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Zip | 47143-9368
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Country | US
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Telephone | 812-736-3076
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 71016942A
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License Number State | IN
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