Provider Demographics
NPI:1891248829
Name:JONES, JODIE (DNP-FNP-C)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:DNP-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 MOFFATT RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-2746
Mailing Address - Country:US
Mailing Address - Phone:724-944-2510
Mailing Address - Fax:
Practice Address - Street 1:3128 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1132
Practice Address - Country:US
Practice Address - Phone:724-654-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016358363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily