Provider Demographics
NPI:1508823584
Name:JONES, MARY I (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:I
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5665 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 172
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1701
Mailing Address - Country:US
Mailing Address - Phone:404-851-5400
Mailing Address - Fax:404-851-5401
Practice Address - Street 1:5665 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 172
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1701
Practice Address - Country:US
Practice Address - Phone:404-851-5400
Practice Address - Fax:404-851-5401
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN047344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q65444Medicare UPIN
50BBBKDWMedicare ID - Type Unspecified