Provider Demographics
NPI:1114738713
Name:JONES, RAVEN ALEXIS (APRN)
Entity type:Individual
Prefix:
First Name:RAVEN
Middle Name:ALEXIS
Last Name:JONES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 JONES TOWN CIR
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-8052
Mailing Address - Country:US
Mailing Address - Phone:423-585-7956
Mailing Address - Fax:
Practice Address - Street 1:156 ISLAND CREEK RD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-9340
Practice Address - Country:US
Practice Address - Phone:606-432-3221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4020262363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics