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NPI Code Detail

MEDICARE: MRS. TOMMIE K JONES C.F.N.P.

MEDICARE: MRS. TOMMIE K JONES C.F.N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerR859956MS

General Provider Information

NPI Number : 1023187689
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TOMMIE K JONES C.F.N.P.
Provider Business Mailing Address
First Line : 965 RIDGE LAKE BLVD STE 103
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-9446
Country : US
Telephone Number :
Fax Number : 901-227-8591
Provider Business Practice Location Address
First Line : 310 ELLIS ST
Second Line :
City : CARTHAGE
State : MS
Zip : 39051-3809
Country : US
Telephone Number : 601-267-1480
Fax Number : 601-253-0176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 11/20/2020

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