Provider Demographics
NPI:1790299626
Name:JONES, VIVIAN DANITA (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:DANITA
Last Name:JONES
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:DR
Other - First Name:VIVIAN
Other - Middle Name:DANITA
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, FNP-C
Mailing Address - Street 1:16131 N ELDRIDGE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-9130
Mailing Address - Country:US
Mailing Address - Phone:830-998-5889
Mailing Address - Fax:
Practice Address - Street 1:16131 N ELDRIDGE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-9130
Practice Address - Country:US
Practice Address - Phone:830-998-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135029363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner