Provider Demographics
NPI:1083808026
Name:JONES, ALLEN EUGENE (CPNP)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:EUGENE
Last Name:JONES
Suffix:
Gender:M
Credentials:CPNP
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 358
Mailing Address - Street 2:
Mailing Address - City:CROWNPOINT
Mailing Address - State:NM
Mailing Address - Zip Code:87313
Mailing Address - Country:US
Mailing Address - Phone:505-786-2559
Mailing Address - Fax:505-786-6435
Practice Address - Street 1:JCT HWY 371 & NAVAJO ROUTE 9
Practice Address - Street 2:
Practice Address - City:CROWNPOINT
Practice Address - State:NM
Practice Address - Zip Code:87313
Practice Address - Country:US
Practice Address - Phone:505-786-2559
Practice Address - Fax:505-786-6435
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02925363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics