Provider Demographics
NPI:1689742777
Name:JONES, SHARON GUSTAFSON (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:GUSTAFSON
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:GUSTAFSON
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6305 DRILL FIELD CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2311
Mailing Address - Country:US
Mailing Address - Phone:703-968-4007
Mailing Address - Fax:703-263-1724
Practice Address - Street 1:14150 PARKEAST CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-2295
Practice Address - Country:US
Practice Address - Phone:703-968-4007
Practice Address - Fax:703-263-1724
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult