Provider Demographics
NPI:1134212178
Name:JONES, MARTHA JANE (FNPC)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:JANE
Last Name:JONES
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6028 PAPER FLOWER PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-8219
Mailing Address - Country:US
Mailing Address - Phone:505-797-7297
Mailing Address - Fax:505-797-7345
Practice Address - Street 1:9809 CANDELARIA RD NE
Practice Address - Street 2:SUITE 3A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1458
Practice Address - Country:US
Practice Address - Phone:505-294-1577
Practice Address - Fax:505-294-0182
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR48426363LF0000X
CO91651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM48124737Medicaid
NM48124737Medicaid