Provider Demographics
NPI:1043284383
Name:JONES, LINDA J (NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:JONES
Suffix:
Gender:F
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:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-292-7333
Mailing Address - Fax:843-292-7324
Practice Address - Street 1:3032 E HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-7396
Practice Address - Country:US
Practice Address - Phone:843-292-7333
Practice Address - Fax:843-292-7324
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 742363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0211Medicaid
SCS662418552Medicare UPIN
SCS66241Medicare UPIN