Provider Demographics
NPI:1104650845
Name:JEMISON, MONA MARJORIE (FNP, ENP)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:MARJORIE
Last Name:JEMISON
Suffix:
Gender:F
Credentials:FNP, ENP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2624 COUNTY ROAD 156
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76273-6111
Mailing Address - Country:US
Mailing Address - Phone:903-267-6332
Mailing Address - Fax:
Practice Address - Street 1:500 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7354
Practice Address - Country:US
Practice Address - Phone:903-870-4611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1169647363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily