Provider Demographics
NPI:1528004249
Name:JONES, MONICA M, (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:M,
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 DALLIS DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-7555
Mailing Address - Country:US
Mailing Address - Phone:662-537-7637
Mailing Address - Fax:
Practice Address - Street 1:930 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-4111
Practice Address - Country:US
Practice Address - Phone:662-332-1398
Practice Address - Fax:662-332-7107
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR836674163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0385905-22OtherANCC
MSQ15194Medicare UPIN
MS500001612Medicare ID - Type Unspecified