Provider Demographics
NPI:1386206688
Name:JONES, TASHA LATIYA (DNP, CRNP)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:LATIYA
Last Name:JONES
Suffix:
Gender:F
Credentials:DNP, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 SAINT LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36602-2825
Mailing Address - Country:US
Mailing Address - Phone:251-422-4336
Mailing Address - Fax:
Practice Address - Street 1:358 SAINT LOUIS ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602-2825
Practice Address - Country:US
Practice Address - Phone:251-372-0858
Practice Address - Fax:251-494-2034
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-094712363LP0808X, 363LG0600X
FL11003033363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health