Provider Demographics
NPI:1972950723
Name:JONAS, JUSTIN (NP)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:JONAS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 S STERLING ST STE 530
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4093
Mailing Address - Country:US
Mailing Address - Phone:828-580-4230
Mailing Address - Fax:828-580-4239
Practice Address - Street 1:2209 S STERLING ST STE 530
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4093
Practice Address - Country:US
Practice Address - Phone:828-580-4230
Practice Address - Fax:828-580-4239
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily