Provider Demographics
NPI:1194163022
Name:JONES - GANT, MARY AGNES (RN, RRT, APRN-BC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:AGNES
Last Name:JONES - GANT
Suffix:
Gender:F
Credentials:RN, RRT, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4735 OGLETOWN STANTON RD
Mailing Address - Street 2:SUITE 2110
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2072
Mailing Address - Country:US
Mailing Address - Phone:302-623-2610
Mailing Address - Fax:302-623-2611
Practice Address - Street 1:4735 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE 2110
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2072
Practice Address - Country:US
Practice Address - Phone:302-623-2610
Practice Address - Fax:302-623-2611
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DELG-0011574363LF0000X
DELN-0000125364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical