Provider Demographics
NPI:1437509692
Name:JONES, JESSICA (CNIM/REEGT/RNCST)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CNIM/REEGT/RNCST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 OLD HICKORY BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5387
Mailing Address - Country:US
Mailing Address - Phone:484-351-8459
Mailing Address - Fax:484-351-8810
Practice Address - Street 1:750 OLD HICKORY BLVD STE 150
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5387
Practice Address - Country:US
Practice Address - Phone:484-351-8459
Practice Address - Fax:484-351-8810
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2221246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic