Provider Demographics
NPI:1831494582
Name:JONES, TAMMY DENISE (RNC, WHNP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:DENISE
Last Name:JONES
Suffix:
Gender:F
Credentials:RNC, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-5711
Mailing Address - Country:US
Mailing Address - Phone:252-446-0027
Mailing Address - Fax:252-985-4539
Practice Address - Street 1:322 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-5711
Practice Address - Country:US
Practice Address - Phone:252-446-0027
Practice Address - Fax:252-985-4539
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20989363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCZF0000063Medicaid