MEDICARE: BETTY JEAN 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	215025	AR

General Provider Information

NPI Number	:	1407519531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY JEAN JONES FNP

Provider Business Mailing Address
First Line	:	917 N FORREST ST
Second Line	:
City	:	FORREST CITY
State	:	AR
Zip	:	72335-2868
Country	:	US
Telephone Number	:	901-201-7193
Fax Number	:	870-638-8086

Provider Business Practice Location Address
First Line	:	917 N FORREST ST
Second Line	:
City	:	FORREST CITY
State	:	AR
Zip	:	72335-2868
Country	:	US
Telephone Number	:	901-201-7193
Fax Number	:

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

Provider Enumeration Date	:	10/15/2021
Last Update Date	:	04/24/2025

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