Provider Demographics
NPI:1083731558
Name:JONES, LYNDA L (NP-C)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 N DOBSON RD
Mailing Address - Street 2:STE C48
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4226
Mailing Address - Country:US
Mailing Address - Phone:480-899-9430
Mailing Address - Fax:480-899-6980
Practice Address - Street 1:595 N DOBSON RD
Practice Address - Street 2:STE C48
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4226
Practice Address - Country:US
Practice Address - Phone:480-899-9430
Practice Address - Fax:480-899-6980
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1015363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN108898OtherRN LICENSE NUMBER
AZMJ0815855OtherDEA NUMBER
AZ67590Medicare ID - Type Unspecified
S64122Medicare UPIN