Provider Demographics
NPI:1770216202
Name:JONES, VALORIE ANNETTE (PMHNP)
Entity Type:Individual
Prefix:
First Name:VALORIE
Middle Name:ANNETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:VALORIE
Other - Middle Name:ANNETTE
Other - Last Name:MYRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3600 S NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-7311
Mailing Address - Country:US
Mailing Address - Phone:417-322-6622
Mailing Address - Fax:417-350-1935
Practice Address - Street 1:2005 W ELM ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-4018
Practice Address - Country:US
Practice Address - Phone:417-322-6622
Practice Address - Fax:417-350-1935
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022033690363LP0808X
AR221015363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR221015OtherAR LICENSE
AR288202758Medicaid
MO420114276Medicaid