Provider Demographics
NPI:1033908546
Name:CLERMONT, MIA JONES
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:JONES
Last Name:CLERMONT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2061 ELK SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1661
Mailing Address - Country:US
Mailing Address - Phone:678-557-1314
Mailing Address - Fax:
Practice Address - Street 1:2061 ELK SPRINGS DR
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1661
Practice Address - Country:US
Practice Address - Phone:678-557-1314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN281436163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse