Provider Demographics
NPI:1033119425
Name:JONES, DEANNA CRAVEN
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:CRAVEN
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 ARROWHEAD BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7637
Mailing Address - Country:US
Mailing Address - Phone:919-563-3007
Mailing Address - Fax:
Practice Address - Street 1:3940 ARROWHEAD BLVD STE 220
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7637
Practice Address - Country:US
Practice Address - Phone:919-563-3007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2021-09-28
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-10
Provider Licenses
StateLicense IDTaxonomies
NC25604207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8946923Medicaid
NC46923OtherBLUE CROSS BLUE SHIELD ID
NC46923OtherBLUE CROSS BLUE SHIELD ID
NC8946923Medicaid
NC207649CMedicare PIN