Provider Demographics
NPI:1598791337
Name:JONES, CAROLYN RAE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:RAE
Last Name:JONES
Suffix:
Gender:F
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 1:509 MAYFAIR NOTCH
Mailing Address - Street 2:
Mailing Address - City:OCEAN ISLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28469-6141
Mailing Address - Country:US
Mailing Address - Phone:910-579-9191
Mailing Address - Fax:
Practice Address - Street 1:800 21ST AVE N
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-7424
Practice Address - Country:US
Practice Address - Phone:843-448-8407
Practice Address - Fax:843-448-7499
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPRN 2143363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily