Doctor Name: | MS. TINA J JONES |
NPI Number: | 1306109806 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN-BC |
License Number: | 209.009366 |
Business Practice Address: | 2246 State Illinois Rt 157 Meridian Center 1 Suite 225 Glen Carbon, IL - 620341717 |
Business Phone Number: | 6182886722 |
Business Fax Number: | |
Mailing Address: | 2246 State Illinois Rt 157, Meridian Center 1 Suite 225 GLEN CARBON |
State: | IL |
Postal Code: | 620341717 |
Phone Number: | 6182886722 |
Fax Number: | |
NPI Enumeration Date: | 06/19/2012 |
NPI Last Update Date: | 06/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 209.009366 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |