Provider Demographics
NPI:1063512754
Name:JONES-TALLEY, EVELYN (FNP)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:
Last Name:JONES-TALLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1548 DEXTER RUN E
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-8726
Mailing Address - Country:US
Mailing Address - Phone:901-755-6575
Mailing Address - Fax:
Practice Address - Street 1:1210 PEABODY AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-4506
Practice Address - Country:US
Practice Address - Phone:901-272-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily