Provider Demographics
NPI:1346522281
Name:JONES, TESHIA WHITAKER (PA)
Entity Type:Individual
Prefix:
First Name:TESHIA
Middle Name:WHITAKER
Last Name:JONES
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:200 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4358
Mailing Address - Country:US
Mailing Address - Phone:704-874-1904
Mailing Address - Fax:704-867-2134
Practice Address - Street 1:1255 CREEKSHIRE WAY STE 270
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3061
Practice Address - Country:US
Practice Address - Phone:336-701-3111
Practice Address - Fax:888-757-4153
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2024-02-22
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Provider Licenses
StateLicense IDTaxonomies
NC0010-03111363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant