Provider Demographics
NPI:1134328990
Name:RICHARDS JONES, DJIFA (PA C)
Entity Type:Individual
Prefix:MRS
First Name:DJIFA
Middle Name:
Last Name:RICHARDS JONES
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 W PARK PLACE BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3543
Mailing Address - Country:US
Mailing Address - Phone:678-722-8464
Mailing Address - Fax:
Practice Address - Street 1:2240 W PARK PLACE BLVD
Practice Address - Street 2:STE A
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3543
Practice Address - Country:US
Practice Address - Phone:678-722-8464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004547363AM0700X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No374J00000XNursing Service Related ProvidersDoula