Provider Demographics
NPI:1265735112
Name:JONES, NETISTA DESHONDA (NP-C)
Entity type:Individual
Prefix:
First Name:NETISTA
Middle Name:DESHONDA
Last Name:JONES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11523
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-1523
Mailing Address - Country:US
Mailing Address - Phone:205-212-5600
Mailing Address - Fax:205-212-5660
Practice Address - Street 1:1600 20TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-4998
Practice Address - Country:US
Practice Address - Phone:205-212-5600
Practice Address - Fax:205-212-5660
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-112171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily