Provider Demographics
NPI:1720322688
Name:JONES, STEPHEN DAVID (NP)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:DAVID
Last Name:JONES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 BENTRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-0590
Mailing Address - Country:US
Mailing Address - Phone:109-784-0261
Mailing Address - Fax:910-938-1118
Practice Address - Street 1:2350 BENTRIDGE LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-0590
Practice Address - Country:US
Practice Address - Phone:109-784-0261
Practice Address - Fax:910-938-1118
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009320363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health