Provider Demographics
NPI:1245425412
Name:JONES, MARTTY JO (CRNP)
Entity Type:Individual
Prefix:MS
First Name:MARTTY
Middle Name:JO
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:MARTTY
Other - Middle Name:JO
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 HOSPITAL CIR
Mailing Address - Street 2:
Mailing Address - City:LUVERNE
Mailing Address - State:AL
Mailing Address - Zip Code:36049-7329
Mailing Address - Country:US
Mailing Address - Phone:334-335-3374
Mailing Address - Fax:
Practice Address - Street 1:101 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:AL
Practice Address - Zip Code:36049-7329
Practice Address - Country:US
Practice Address - Phone:334-335-3374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1101024363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner