Provider Demographics
NPI:1053030585
Name:JONES, TERESA (NP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:GOODWATER
Mailing Address - State:AL
Mailing Address - Zip Code:35072-5554
Mailing Address - Country:US
Mailing Address - Phone:404-980-2040
Mailing Address - Fax:
Practice Address - Street 1:985 PROSPECT RD
Practice Address - Street 2:
Practice Address - City:GOODWATER
Practice Address - State:AL
Practice Address - Zip Code:35072-5554
Practice Address - Country:US
Practice Address - Phone:404-980-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-108151363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care