Provider Demographics
NPI:1578296968
Name:JONES, ADRIAN BRYAN (CNP)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:BRYAN
Last Name:JONES
Suffix:
Gender:M
Credentials:CNP
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 284
Mailing Address - Street 2:
Mailing Address - City:BALTIC
Mailing Address - State:SD
Mailing Address - Zip Code:57003-0284
Mailing Address - Country:US
Mailing Address - Phone:505-215-8877
Mailing Address - Fax:
Practice Address - Street 1:4308 S ARWAY DR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3131
Practice Address - Country:US
Practice Address - Phone:605-573-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002437363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health