Individual
SHANNON JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
2205 PAVILION DR, SUITE 201, KINGSPORT, TN 37660-4641
(423) 857-7650
(423) 857-7655
Mailing address
2205 PAVILION DR, SUITE 201, KINGSPORT, TN 37660-4641
(423) 857-7650
(423) 857-7655
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
0024165076
VA
363LA2100X
Acute Care Nurse Practitioner
Primary
7943
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376512806
—
VA
05
—
3908176
—
TN
01
—
P00121865
RAILROAD MEDICARE
TN
Enumeration date
03/16/2006
Last updated
02/10/2017
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