Provider Demographics
NPI:1770923724
Name:JONES, AMBER DAWN (FNP-MSN-BC)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:DAWN
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP-MSN-BC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:DAWN
Other - Last Name:LYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-MSN-BC
Mailing Address - Street 1:10 MONTGOMERY DR
Mailing Address - Street 2:
Mailing Address - City:CADDO VALLEY
Mailing Address - State:AR
Mailing Address - Zip Code:71923-8901
Mailing Address - Country:US
Mailing Address - Phone:870-245-2198
Mailing Address - Fax:870-245-2298
Practice Address - Street 1:10 MONTGOMERY DR
Practice Address - Street 2:
Practice Address - City:CADDO VALLEY
Practice Address - State:AR
Practice Address - Zip Code:71923
Practice Address - Country:US
Practice Address - Phone:870-245-2198
Practice Address - Fax:870-245-2298
Is Sole Proprietor?:No
Enumeration Date:2013-07-04
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003943363LF0000X
MO2013023056363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR201200758Medicaid