Provider Demographics
NPI:1194466912
Name:JONES, ANITA DAWN (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:DAWN
Last Name:JONES
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CLAYFIELD LN
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-9741
Mailing Address - Country:US
Mailing Address - Phone:304-553-8905
Mailing Address - Fax:
Practice Address - Street 1:3100 MACCORKLE AVE SE STE 406
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1230
Practice Address - Country:US
Practice Address - Phone:304-388-5967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV112294363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health