Provider Demographics
NPI:1164011607
Name:JONES, JESSICA W (RN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:W
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 KOBY LN
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-6045
Mailing Address - Country:US
Mailing Address - Phone:662-809-1615
Mailing Address - Fax:
Practice Address - Street 1:1425 KOBY LN
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-6045
Practice Address - Country:US
Practice Address - Phone:662-809-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS898328163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse