Provider Demographics
NPI:1215416250
Name:JONES, CHRISTA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 JEFFERSON DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-5107
Mailing Address - Country:US
Mailing Address - Phone:601-446-6634
Mailing Address - Fax:601-446-6898
Practice Address - Street 1:150 JEFFERSON DAVIS BLVD
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-5107
Practice Address - Country:US
Practice Address - Phone:601-446-6634
Practice Address - Fax:601-446-6898
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902830363LP0808X
MSR857803363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health