Provider Demographics
NPI:1497443014
Name:JONES-BBOSA, TIARRA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:TIARRA
Middle Name:
Last Name:JONES-BBOSA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 HAYMAN DR
Mailing Address - Street 2:
Mailing Address - City:FEDERALSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21632-2626
Mailing Address - Country:US
Mailing Address - Phone:410-754-2440
Mailing Address - Fax:
Practice Address - Street 1:3304 HAYMAN DR
Practice Address - Street 2:
Practice Address - City:FEDERALSBURG
Practice Address - State:MD
Practice Address - Zip Code:21632-2626
Practice Address - Country:US
Practice Address - Phone:410-754-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR238124363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily