Provider Demographics
NPI:1568950426
Name:JONES, MICHAEL ANTHONY (FNP-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:JONES
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BROOKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-9478
Mailing Address - Country:US
Mailing Address - Phone:864-908-6442
Mailing Address - Fax:
Practice Address - Street 1:123 COUCH LN
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-1916
Practice Address - Country:US
Practice Address - Phone:910-742-9243
Practice Address - Fax:404-341-9243
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21855363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily