Provider Demographics
NPI:1902905920
Name:JONES, TEDDY LYNN (RN, FNP, PHD)
Entity Type:Individual
Prefix:MS
First Name:TEDDY
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:RN, FNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 734
Mailing Address - Street 2:
Mailing Address - City:FRIONA
Mailing Address - State:TX
Mailing Address - Zip Code:79035-0734
Mailing Address - Country:US
Mailing Address - Phone:806-638-1955
Mailing Address - Fax:806-265-3525
Practice Address - Street 1:2021 W 21ST ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-4086
Practice Address - Country:US
Practice Address - Phone:505-935-7777
Practice Address - Fax:505-935-7778
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218392363LF0000X
NMR36172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFNP002422Medicaid
TXFNP002422Medicaid