Provider Demographics
NPI:1841595279
Name:JONES, BEVERLY K (NP-C)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:K
Last Name:JONES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 VALERIE DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-4505
Mailing Address - Country:US
Mailing Address - Phone:228-547-5160
Mailing Address - Fax:
Practice Address - Street 1:1721 MEDICAL PARK DR STE 101
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2105
Practice Address - Country:US
Practice Address - Phone:228-385-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-15
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR645729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily