Provider Demographics
NPI:1730299082
Name:JONES, KATHRYN B (NP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:B
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1126
Mailing Address - Country:US
Mailing Address - Phone:980-280-4010
Mailing Address - Fax:980-280-4011
Practice Address - Street 1:2200 RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1126
Practice Address - Country:US
Practice Address - Phone:980-280-4010
Practice Address - Fax:980-280-4011
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC960002363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS23640Medicare UPIN