Provider Demographics
NPI:1790709756
Name:JONES, PAULA D (FNP)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:D
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 1:241 SILVERWOOD COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-5164
Mailing Address - Country:US
Mailing Address - Phone:912-826-8820
Mailing Address - Fax:912-826-8805
Practice Address - Street 1:241 SILVERWOOD COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326
Practice Address - Country:US
Practice Address - Phone:912-826-8820
Practice Address - Fax:912-826-8805
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN104371363L00000X, 363LF0000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA50BBKMCOtherOLD MEDICARE PTAN - TERM'D 9/29/07 FOR NON-BILLING
GA930276241BMedicaid
GA930276241AMedicaid
GA930276241AMedicaid
Q70514Medicare UPIN