Provider Demographics
NPI:1225191653
Name:JONES, DALAN (FNP)
Entity Type:Individual
Prefix:
First Name:DALAN
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 GREYSTONE SQ
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3580
Mailing Address - Country:US
Mailing Address - Phone:731-668-7375
Mailing Address - Fax:731-668-2727
Practice Address - Street 1:1004 GREYSTONE SQ
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3580
Practice Address - Country:US
Practice Address - Phone:731-668-7375
Practice Address - Fax:731-668-2727
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN12347363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner