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General NPI Number Information
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NPI Number | 1700499241
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Entity Type | Individual
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Provider Name | MALLORY JONES CFNP
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Gender | Female
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 516B LINCOLN RD
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City | COLUMBUS
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State | MS
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Zip | 39705-2226
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Country | US
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Telephone | 662-243-0008
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Fax | 662-570-4264
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Provider Business Mailing Address
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Address Line | 516B LINCOLN RD
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City | COLUMBUS
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State | MS
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Zip | 39705-2226
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Country | US
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Telephone | 662-243-0008
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Fax | 662-570-4264
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 904088
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License Number State | MS
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