Provider Demographics
NPI:1053084509
Name:JONES, EBONY DIONE (FNP-C)
Entity type:Individual
Prefix:
First Name:EBONY
Middle Name:DIONE
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 1:318 N PARKDALE DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-4858
Mailing Address - Country:US
Mailing Address - Phone:903-360-0580
Mailing Address - Fax:
Practice Address - Street 1:413 W ROSEDALE ST
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4808
Practice Address - Country:US
Practice Address - Phone:817-348-8082
Practice Address - Fax:817-570-0709
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX1143012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program