Provider Demographics
NPI:1316458870
Name:JONES, SUSAN MARY (AGNP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARY
Last Name:JONES
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Gender:F
Credentials:AGNP
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8233
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-514-3500
Mailing Address - Fax:314-747-2598
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:DIV ORTHO SURG ADULT RECONSTRUCTIVE SURG
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-747-2551
Practice Address - Fax:314-747-2598
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2021-11-15
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Provider Licenses
StateLicense IDTaxonomies
MO2017035894363LG0600X, 363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420061008Medicaid