Provider Demographics
NPI:1457062259
Name:JONES, ASHANTA RENE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ASHANTA
Middle Name:RENE
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 AMBERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-4524
Mailing Address - Country:US
Mailing Address - Phone:601-920-7236
Mailing Address - Fax:
Practice Address - Street 1:4635 HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-4226
Practice Address - Country:US
Practice Address - Phone:601-825-8130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily