Provider Demographics
NPI:1659932218
Name:JONES, ALITHA DEVONNA (AGACNP-BC, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ALITHA
Middle Name:DEVONNA
Last Name:JONES
Suffix:
Gender:F
Credentials:AGACNP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:692 LAKE CAROLYN PKWY APT 343E
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-3946
Mailing Address - Country:US
Mailing Address - Phone:682-227-0988
Mailing Address - Fax:
Practice Address - Street 1:692 LAKE CAROLYN PKWY APT 343E
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3946
Practice Address - Country:US
Practice Address - Phone:682-227-0988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX190574163WC0200X
TXAP143034363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190574OtherTEXAS BON
2019010994OtherAMERICAN NURSE CREDENTIALING CENTER (ANCC)
2019010996OtherAMERICAN NURSE CREDENTIALING CENTER (ANCC)
TXAP143034OtherTEXAS BON