Provider Demographics
NPI:1194066282
Name:JONES, HILLARY MEAD (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HILLARY
Middle Name:MEAD
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:HILLARY
Other - Middle Name:BARBARA
Other - Last Name:MEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:590 HILLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-5910
Mailing Address - Country:US
Mailing Address - Phone:931-261-8638
Mailing Address - Fax:
Practice Address - Street 1:1200 FLEETGUARD RD
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-6258
Practice Address - Country:US
Practice Address - Phone:931-528-9499
Practice Address - Fax:931-372-9878
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2284363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ007469Medicaid