1801057427 NPI number — MRS. ANITA CAROLE JONES CPNP

Table of content: MRS. ANITA CAROLE JONES CPNP (NPI 1801057427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801057427 NPI number — MRS. ANITA CAROLE JONES CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
ANITA
Provider Middle Name:
CAROLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CPNP
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:
1801057427
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3821 THE PRADO
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MACON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31204-1361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
478-951-0078
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1508B HARDEMAN AVE
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
MACON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31201-1471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-741-7337
Provider Business Practice Location Address Fax Number:
478-741-7371
Provider Enumeration Date:
06/17/2008

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: 363LP0200X , with the licence number:  RN066948 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 94151 . This is a "PEDIATRIC NURSING CERTIFICATION BOARD" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 00691567D , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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