Provider Demographics
NPI:1235457102
Name:JINES, PAMELA (MED)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:JINES
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5185 HIGHWAY 33 S
Mailing Address - Street 2:
Mailing Address - City:NEW TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37825-2532
Mailing Address - Country:US
Mailing Address - Phone:865-660-0359
Mailing Address - Fax:
Practice Address - Street 1:1531 DICK LONAS RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1259
Practice Address - Country:US
Practice Address - Phone:865-602-2021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health