Provider Demographics
NPI:1225735269
Name:JONES, BROOKLYN NICOLE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:NICOLE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 ATHENS RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-6261
Mailing Address - Country:US
Mailing Address - Phone:304-425-0716
Mailing Address - Fax:304-487-1322
Practice Address - Street 1:756 ATHENS RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-6261
Practice Address - Country:US
Practice Address - Phone:304-425-0716
Practice Address - Fax:304-487-1322
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant