1790937019 NPI number — THERESA ANN JONES RN MS FNP-BC

Table of content: THERESA ANN JONES RN MS FNP-BC (NPI 1790937019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790937019 NPI number — THERESA ANN JONES RN MS FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
THERESA
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN MS FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790937019
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
651 N HIGHWAY 183
Provider Second Line Business Mailing Address:
STE 110
Provider Business Mailing Address City Name:
LEANDER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78641-7002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-528-0432
Provider Business Mailing Address Fax Number:
512-528-0452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
651 N HIGHWAY 183
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
LEANDER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78641-7001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-528-0432
Provider Business Practice Location Address Fax Number:
512-528-0452
Provider Enumeration Date:
10/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  666174 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 666174 . This is a "BOARD OF NURSE EXAMINERS FOR THE STATE OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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