Provider Demographics
NPI:1851336663
Name:JONES, HEATHER INGRAM (PAC)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:INGRAM
Last Name:JONES
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1990 DOVER RD UNIT 201
Mailing Address - Street 2:
Mailing Address - City:EPSOM
Mailing Address - State:NH
Mailing Address - Zip Code:03234-4146
Mailing Address - Country:US
Mailing Address - Phone:603-736-6200
Mailing Address - Fax:603-227-7561
Practice Address - Street 1:1990 DOVER RD UNIT 201
Practice Address - Street 2:
Practice Address - City:EPSOM
Practice Address - State:NH
Practice Address - Zip Code:03234-4146
Practice Address - Country:US
Practice Address - Phone:603-736-6200
Practice Address - Fax:603-227-7561
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0473363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant