Provider Demographics
NPI:1457062259
Name:JONES, ASHANTA RENE (FNP-C)
Entity type:Individual
Prefix:
First Name:ASHANTA
Middle Name:RENE
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SERIO BLVD
Mailing Address - Street 2:
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334-2015
Mailing Address - Country:US
Mailing Address - Phone:318-757-0210
Mailing Address - Fax:318-757-9916
Practice Address - Street 1:204 SERIO BLVD
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334-2015
Practice Address - Country:US
Practice Address - Phone:318-757-0210
Practice Address - Fax:318-757-9916
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily