1649332008 NPI number — ANNA CHRISTINE JONES FNP-C; GNP-BC

Table of content: ANNA CHRISTINE JONES FNP-C; GNP-BC (NPI 1649332008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649332008 NPI number — ANNA CHRISTINE JONES FNP-C; GNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
ANNA
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-C; GNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649332008
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 CENTRAL PLZ # 418
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROME
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30161-3233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-309-2092
Provider Business Mailing Address Fax Number:
855-486-9205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 TOM MURPHY INDUSTRIAL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BREMEN
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-309-2092
Provider Business Practice Location Address Fax Number:
855-486-9205
Provider Enumeration Date:
12/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  RN151386 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LG0600X , with the licence number: RN151386 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 975550037C , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 975550037E , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".