Provider Demographics
NPI:1003290974
Name:JONES, MARILYN ANN (NP)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2867 BLOOMSBURY S
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7163
Mailing Address - Country:US
Mailing Address - Phone:317-402-6341
Mailing Address - Fax:
Practice Address - Street 1:2867 BLOOMSBURY S
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-7163
Practice Address - Country:US
Practice Address - Phone:317-402-6341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71005759A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily