Provider Demographics
NPI:1396966909
Name:JONES, JANINE ROXANNE (CNM)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:ROXANNE
Last Name:JONES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 DULUTH HWY STE 801
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-8709
Mailing Address - Country:US
Mailing Address - Phone:470-325-0148
Mailing Address - Fax:770-339-0485
Practice Address - Street 1:1942 ATKINSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5004
Practice Address - Country:US
Practice Address - Phone:678-775-0600
Practice Address - Fax:678-377-5284
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN093541367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00870306BMedicare ID - Type Unspecified