Provider Demographics
NPI:1568501096
Name:JONES, TINA MARIE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:TINA
Other - Middle Name:MARIE
Other - Last Name:DICKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:6820 OLD BRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2661
Mailing Address - Country:US
Mailing Address - Phone:018-498-4409
Mailing Address - Fax:901-565-8787
Practice Address - Street 1:3725 CHAMPION HILLS DR
Practice Address - Street 2:SUITE 2000
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-2597
Practice Address - Country:US
Practice Address - Phone:901-367-9001
Practice Address - Fax:901-565-8787
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN129376363LF0000X
TN8128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily