Provider Demographics
NPI:1700036977
Name:JONES, ELIZABETH ANNE (APN-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:JONES
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MERIDIAN CENTRE BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3981
Mailing Address - Country:US
Mailing Address - Phone:518-605-9796
Mailing Address - Fax:
Practice Address - Street 1:300 MERIDIAN CENTRE BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3981
Practice Address - Country:US
Practice Address - Phone:518-605-9796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303250363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMJ1714737OtherDEA