Provider Demographics
NPI:1275557449
Name:JONES, DORIS JANE (ARNP)
Entity Type:Individual
Prefix:MISS
First Name:DORIS
Middle Name:JANE
Last Name:JONES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 N NOVA RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4447
Mailing Address - Country:US
Mailing Address - Phone:386-672-7175
Mailing Address - Fax:386-672-0771
Practice Address - Street 1:533 N NOVA RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4447
Practice Address - Country:US
Practice Address - Phone:386-672-7175
Practice Address - Fax:386-672-0771
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP31089363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7022BMedicare PIN