Individual
ILSA JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1715 SPLIT RIDGE RD, KNOXVILLE, TN 37922-5738
(503) 717-2003
Mailing address
1715 SPLIT RIDGE RD, KNOXVILLE, TN 37922-5738
(503) 717-2003
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
202409
TN
363L00000X
Nurse Practitioner
Primary
19047
TN
363LP2300X
Primary Care Nurse Practitioner
6600-33
WI
Other
Enumeration date
08/24/2015
Last updated
10/10/2024
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