Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 13961 | TN |
NPI | 1003057167 |
---|---|
Provider Name | Mrs. Sara A Jones |
First Address | Nashville, TN 37244-0509 |
Second Address | Knoxville, TN 37920-1545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2009 |
Last Update Date | 27/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1514121 | (05) | TN |