Provider Demographics
NPI:1871084590
Name:JONES, NICOLETTE (APN, FNP-BC)
Entity type:Individual
Prefix:
First Name:NICOLETTE
Middle Name:
Last Name:JONES
Suffix:
Gender:
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:NICOLETTE
Other - Middle Name:
Other - Last Name:AMBROSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APN, FNP-BC
Mailing Address - Street 1:7855 MARQUETTE DR S
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-4560
Mailing Address - Country:US
Mailing Address - Phone:708-429-2238
Mailing Address - Fax:
Practice Address - Street 1:19070 EVERETT BLVD UNIT 202
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-2073
Practice Address - Country:US
Practice Address - Phone:708-479-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016975363LF0000X
IL209.016975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily