Provider Demographics
NPI:1578145504
Name:JONES, IVY N
Entity Type:Individual
Prefix:
First Name:IVY
Middle Name:N
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CENTRAL EXPY S STE 400
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8113
Mailing Address - Country:US
Mailing Address - Phone:844-688-4866
Mailing Address - Fax:844-688-4878
Practice Address - Street 1:700 CENTRAL EXPY S STE 400
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8113
Practice Address - Country:US
Practice Address - Phone:844-688-4866
Practice Address - Fax:844-688-4878
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2020117517363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health