Provider Demographics
NPI:1205261930
Name:JONES, JULIE C (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:C
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:C
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6401 PATTERSON PKWY
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-5701
Mailing Address - Country:US
Mailing Address - Phone:620-441-5711
Mailing Address - Fax:
Practice Address - Street 1:6401 PATTERSON PKWY
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-5701
Practice Address - Country:US
Practice Address - Phone:620-441-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2296363A00000X, 363AM0700X, 363AS0400X
KS15-01804363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical