Provider Demographics
NPI:1124083464
Name:JONES, PATRICIA FAITH (ARNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:FAITH
Last Name:JONES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6856 103RD ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-6877
Practice Address - Country:US
Practice Address - Phone:904-777-0616
Practice Address - Fax:904-777-0688
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1318882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303594800Medicaid
FLP25318Medicare UPIN
FLE5135ZMedicare ID - Type UnspecifiedMEDICARE NUMBER
FLE5135XMedicare PIN