Provider Demographics
NPI:1962548909
Name:JONES, WILMA LEE (ARNP)
Entity type:Individual
Prefix:
First Name:WILMA
Middle Name:LEE
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 1:1801 PENN ST
Mailing Address - Street 2:BILLING DEPARTMENT
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-2694
Mailing Address - Country:US
Mailing Address - Phone:888-429-1844
Mailing Address - Fax:
Practice Address - Street 1:1801 PENN ST
Practice Address - Street 2:BILLING DEPARTMENT
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2694
Practice Address - Country:US
Practice Address - Phone:888-429-1844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3193802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily