Provider Demographics
NPI:1821032079
Name:JONES, MARTHA A (NP)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 EBB TIDE LNDG
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1334
Mailing Address - Country:US
Mailing Address - Phone:757-868-0123
Mailing Address - Fax:757-483-2370
Practice Address - Street 1:3300 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-3205
Practice Address - Country:US
Practice Address - Phone:757-483-6404
Practice Address - Fax:757-483-0737
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024166854363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010261121Medicaid