Provider Demographics
NPI:1457509747
Name:JONES, JUDY L (FNP)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1619
Mailing Address - Street 2:
Mailing Address - City:WEST TISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02575-1619
Mailing Address - Country:US
Mailing Address - Phone:508-627-5797
Mailing Address - Fax:
Practice Address - Street 1:245 EDGARTOWN VINEYARD HAVEN RD
Practice Address - Street 2:
Practice Address - City:EDGARTOWN
Practice Address - State:MA
Practice Address - Zip Code:02539-6948
Practice Address - Country:US
Practice Address - Phone:508-627-5797
Practice Address - Fax:508-939-8644
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201505363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily