Provider Demographics
NPI:1497876049
Name:JONES, ROBIN TIDWELL (APRN)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:TIDWELL
Last Name:JONES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7127 SNAPDRAGON LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6555
Mailing Address - Country:US
Mailing Address - Phone:865-216-3351
Mailing Address - Fax:
Practice Address - Street 1:500 W MLK SUITE 1108
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-3444
Practice Address - Country:US
Practice Address - Phone:423-226-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11062363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMT1296917OtherDEA