Provider Demographics
NPI:1609923705
Name:JONES, DAVID SHELDON (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SHELDON
Last Name:JONES
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 ENGLEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-4511
Mailing Address - Country:US
Mailing Address - Phone:336-584-3231
Mailing Address - Fax:
Practice Address - Street 1:617 ENGLEMAN AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-4511
Practice Address - Country:US
Practice Address - Phone:336-584-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39443367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8050697Medicaid
NC260201BMedicare ID - Type UnspecifiedMEDICARE