Individual
TRACY KATHLEEN JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP.C
Contact information
Practice address
6043 PRESTLEY MILL RD, SUITE D, DOUGLASVILLE, GA 30134
(770) 739-9555
(678) 741-2301
Mailing address
1700 HOSPITAL SOUTH DR, SUITE 502 GASTROINTESTINAL SPECIALISTS OF GA, PC, AUSTCEE, GA 30106
(678) 741-5000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN112762
GA
363L00000X
Nurse Practitioner
Primary
RN112762
GA
363LF0000X
Family Nurse Practitioner
0340729 22
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000902327A
—
GA
05
—
300035305B
—
GA
01
—
50BBDWC
MEDICARE
—
05
—
651375375A
—
GA
01
—
CEP12680
RN PROVIDER ID
—
Enumeration date
04/06/2006
Last updated
07/29/2008
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