Provider Demographics
NPI:1255671921
Name:JONES, DAFFANY KAY
Entity Type:Individual
Prefix:
First Name:DAFFANY
Middle Name:KAY
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21105 EVA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-1706
Mailing Address - Country:US
Mailing Address - Phone:936-597-8585
Mailing Address - Fax:
Practice Address - Street 1:21105 EVA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-1706
Practice Address - Country:US
Practice Address - Phone:936-597-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX593509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily