Provider Demographics
NPI:1336183128
Name:JONES, JUDY LYNN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:LYNN
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 1:530 HIGHWAY 64 E STE 4
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-3050
Mailing Address - Country:US
Mailing Address - Phone:931-722-7722
Mailing Address - Fax:
Practice Address - Street 1:530 HIGHWAY 64 E STE 4
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-3050
Practice Address - Country:US
Practice Address - Phone:931-722-7722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006068363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1513078Medicaid
TN203949252OtherAMERICHOICE
TN10069469OtherAMERIGROUP
TN4115277OtherBCBS
TN203949252OtherUNITED HEALTH CARE
TN0278053OtherCIGNA
TN1513142Medicaid
TN10069469OtherAMERIGROUP
TNP04102Medicare UPIN