Provider Demographics
NPI:1699731919
Name:JONES, DEBRA J (PNP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:JONES
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 986513
Mailing Address - Street 2:DEPT 100
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02298-6513
Mailing Address - Country:US
Mailing Address - Phone:910-219-8326
Mailing Address - Fax:910-939-4269
Practice Address - Street 1:8399 RICHLANDS HWY
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28574-7390
Practice Address - Country:US
Practice Address - Phone:910-324-7268
Practice Address - Fax:910-324-7273
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN157526363L00000X
NC5019371363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2134345Medicaid
NC1699731919Medicaid