Provider Demographics
NPI:1992099782
Name:JONES, KATHERINE J (ARNP)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:J
Last Name:JONES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:513 NW LAKE WHITNEY PL STE 101
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-1618
Mailing Address - Country:US
Mailing Address - Phone:772-344-7228
Mailing Address - Fax:772-344-7158
Practice Address - Street 1:513 NW LAKE WHITNEY PL STE 101
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1618
Practice Address - Country:US
Practice Address - Phone:772-344-7228
Practice Address - Fax:772-344-7158
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2825912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily