Provider Demographics
NPI:1649735796
Name:JONES, TAMIKA A
Entity Type:Individual
Prefix:MS
First Name:TAMIKA
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMIKA
Other - Middle Name:A
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC, AG-ACNP-BC
Mailing Address - Street 1:2096 CHESTNUT LOG CIR
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-3521
Mailing Address - Country:US
Mailing Address - Phone:352-308-5700
Mailing Address - Fax:
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-428-0462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-04
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN2391822083P0901X, 2086S0127X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery