Provider Demographics
NPI:1164686614
Name:JONES, CHRIS M (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:CHRISTOPHER
Other - Middle Name:M
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:10000 ZANE AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1400
Mailing Address - Country:US
Mailing Address - Phone:763-528-6999
Mailing Address - Fax:763-528-6930
Practice Address - Street 1:10000 ZANE AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1400
Practice Address - Country:US
Practice Address - Phone:763-528-6999
Practice Address - Fax:763-528-6930
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012604363AM0700X
MN11390363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical