MEDICARE: SAMIYA JONES FNP

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
1	363LF0000X	Family Nurse Practitioner	RN254471	GA
2	363LF0000X	Family Nurse Practitioner	19917	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174910921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIYA JONES FNP

Provider Business Mailing Address
First Line	:	8187 E BRAINERD RD
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-4372
Country	:	US
Telephone Number	:	423-499-7713
Fax Number	:	423-499-7714

Provider Business Practice Location Address
First Line	:	8187 E BRAINERD RD
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-4372
Country	:	US
Telephone Number	:	423-499-7713
Fax Number	:	423-499-7714

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2015
Last Update Date	:	02/18/2026

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