Provider Demographics
NPI:1114679404
Name:JONES, STEPHANIE MICHELE (FNP)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MICHELE
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:MICHELE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:1601 W HEBRON PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-6342
Mailing Address - Country:US
Mailing Address - Phone:724-268-6759
Mailing Address - Fax:972-492-4694
Practice Address - Street 1:1601 W HEBRON PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-6342
Practice Address - Country:US
Practice Address - Phone:724-268-6759
Practice Address - Fax:972-492-4694
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059148363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily