Provider Demographics
NPI:1891087177
Name:JONES, CYNTHIA JUNE (FNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JUNE
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:PO BOX 12938
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30703-7013
Mailing Address - Country:US
Mailing Address - Phone:706-602-7800
Mailing Address - Fax:706-879-5843
Practice Address - Street 1:104 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:GA
Practice Address - Zip Code:30705
Practice Address - Country:US
Practice Address - Phone:706-695-1820
Practice Address - Fax:706-517-3969
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN090459 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000774705EMedicaid
GA202I505278OtherMEDICARE