Provider Demographics
NPI:1316263288
Name:JONES, SUSAN SHAWN (CRNA)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:SHAWN
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:SHAWN
Other - Last Name:SMALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2896
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-662-8593
Practice Address - Street 1:878 FOX DRIVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603
Practice Address - Country:US
Practice Address - Phone:540-662-8336
Practice Address - Fax:540-662-8593
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168733367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered