Provider Demographics
NPI:1154735736
Name:JONES, ANGELA (RNFA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 PEAKE RD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-8042
Mailing Address - Country:US
Mailing Address - Phone:478-737-3468
Mailing Address - Fax:
Practice Address - Street 1:6501 PEAKE RD
Practice Address - Street 2:SUITE 1000
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-8042
Practice Address - Country:US
Practice Address - Phone:478-737-3468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN140447364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RN140447OtherRNFA CERTIFICATE