Provider Demographics
NPI:1396034278
Name:JONES, KRISTIN KAY (ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:KAY
Last Name:JONES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:KAY
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:30 REDVALES RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-8020
Mailing Address - Country:US
Mailing Address - Phone:904-423-7958
Mailing Address - Fax:
Practice Address - Street 1:3930 GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-3163
Practice Address - Country:US
Practice Address - Phone:864-757-5059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9247445363LF0000X
NV822197363LF0000X
NM57696363LF0000X
SC22714A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily