Provider Demographics
NPI:1437541117
Name:JONES, MATTHEW A (NP-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
Last Name:JONES
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 S JEFFERSON ST STE 625
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:540-224-5374
Mailing Address - Fax:540-224-5684
Practice Address - Street 1:1375 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-5011
Practice Address - Country:US
Practice Address - Phone:276-228-8686
Practice Address - Fax:276-228-4052
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172339363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily