Provider Demographics
NPI:1407963663
Name:JONES, ANDREW RICHARD (CRNA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:RICHARD
Last Name:JONES
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2930
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2930
Mailing Address - Country:US
Mailing Address - Phone:844-468-9496
Mailing Address - Fax:855-630-1300
Practice Address - Street 1:975 E. THIRD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2147
Practice Address - Country:US
Practice Address - Phone:423-602-8400
Practice Address - Fax:423-602-8401
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN144680163W00000X
GARN154653163W00000X
TNAPN12514367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009911702Medicaid
TNP00443433OtherRAILROAD MEDICARE
TN3638259Medicaid
NC8052758Medicaid
GA883490704AMedicaid
GAN382696OtherWELLCARE (GA MEDICAID)
TN4158768OtherBLUE CROSS BLUE SHIELD TN
TNP00443433OtherRAILROAD MEDICARE