Provider Demographics
NPI:1730643701
Name:JONES, CHRISTINA (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 BROADWAY ST NE STE 115
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-1759
Mailing Address - Country:US
Mailing Address - Phone:651-312-1505
Mailing Address - Fax:651-312-1570
Practice Address - Street 1:11850 BLACKFOOT ST NW STE 270
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2593
Practice Address - Country:US
Practice Address - Phone:651-312-1717
Practice Address - Fax:651-312-1570
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12789363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical