Provider Demographics
NPI:1386075497
Name:JONES, TANTASHA LATREECE (FNP)
Entity type:Individual
Prefix:MRS
First Name:TANTASHA
Middle Name:LATREECE
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TANTASHA
Other - Middle Name:LATREECE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:10911 CLEAR FORK DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-2461
Mailing Address - Country:US
Mailing Address - Phone:832-289-2706
Mailing Address - Fax:
Practice Address - Street 1:2470 GRAY FALLS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6512
Practice Address - Country:US
Practice Address - Phone:281-978-4520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-29
Last Update Date:2013-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX637058363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily