Provider Demographics
NPI:1619063773
Name:JONES, SUSANNE NEWMAN (FNP)
Entity Type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:NEWMAN
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 SAM FURR RD
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-8911
Mailing Address - Country:US
Mailing Address - Phone:704-896-3671
Mailing Address - Fax:
Practice Address - Street 1:7920 SAM FURR RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-8911
Practice Address - Country:US
Practice Address - Phone:704-896-3671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0050-02024363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2593109Medicare PIN