Basic Information
| Provider Information | |||||||||
| NPI: | 1407454101 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1140 HWY 100 | ||||||||
| Address2: | |||||||||
| City: | CENTERVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9327295551 | ||||||||
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| Practice Location | |||||||||
| Address1: | 210 WESTWOOD PL STE 110 | ||||||||
| Address2: | |||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370277554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152062462 | ||||||||
| FaxNumber: | 8339832043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2020 | ||||||||
| LastUpdateDate: | 07/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 28379 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.