Provider Demographics
NPI:1619050051
Name:JONES, DONNA (PNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ORGAN CRES
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1616
Mailing Address - Country:US
Mailing Address - Phone:716-861-5422
Mailing Address - Fax:716-675-9775
Practice Address - Street 1:22 ORGAN CRES
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14224-1616
Practice Address - Country:US
Practice Address - Phone:716-861-5422
Practice Address - Fax:716-675-9775
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY352798163W00000X
NYF381091363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026903101OtherUNIVERA
NY02581982Medicaid
NY050317000095OtherFIDELIS
NY000560903001OtherBC/BS
NY1020912030001OtherPA MEDICAID
NY9590212OtherIHA
Q30265Medicare UPIN
NY02581982Medicaid