Provider Demographics
NPI:1235292319
Name:JONES, THERESA MARIE (RN,MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:RN,MSN, FNP-C
Other - Prefix:MS
Other - First Name:THERESA
Other - Middle Name:MARIE
Other - Last Name:UTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, FNP-C
Mailing Address - Street 1:2900 LEMAY FERRY RD
Mailing Address - Street 2:STE 104
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-3900
Mailing Address - Country:US
Mailing Address - Phone:314-525-1887
Mailing Address - Fax:314-525-1868
Practice Address - Street 1:2900 LEMAY FERRY RD
Practice Address - Street 2:STE 104
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-3900
Practice Address - Country:US
Practice Address - Phone:314-525-1887
Practice Address - Fax:314-525-1868
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO142840363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily