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General NPI Number Information
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NPI Number | 1770003774
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Entity Type | Individual
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Provider Name | TABATHA YVETTE JONES RN
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Gender | Female
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 506 LEE RD 554
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City | PHENIX CITY
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State | AL
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Zip | 36867
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Country | US
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Telephone | 706-464-2202
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Fax |
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Provider Business Mailing Address
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Address Line | 506 LEE ROAD 554
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City | PHENIX CITY
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State | AL
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Zip | 36867-0980
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Country | US
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Telephone | 706-464-2202
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN165810
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License Number State | GA
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