Provider Demographics
NPI:1184255507
Name:JONES, KENYATTA BRASS (FNP)
Entity type:Individual
Prefix:
First Name:KENYATTA
Middle Name:BRASS
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2237 E RIVERSIDE DR STE 101-C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-3051
Mailing Address - Country:US
Mailing Address - Phone:512-744-6000
Mailing Address - Fax:512-448-3776
Practice Address - Street 1:2237 E RIVERSIDE DR STE 101-C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-3051
Practice Address - Country:US
Practice Address - Phone:512-744-6000
Practice Address - Fax:512-448-3776
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145098363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily