Provider Demographics
NPI:1831343375
Name:JONES, SANDRA J (CRNP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4704 WHITESBURG DR SW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1679
Mailing Address - Country:US
Mailing Address - Phone:256-213-1800
Mailing Address - Fax:256-429-9186
Practice Address - Street 1:4704 WHITESBURG DR SW
Practice Address - Street 2:SUITE 201
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-1679
Practice Address - Country:US
Practice Address - Phone:256-213-1800
Practice Address - Fax:256-429-9186
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1044795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510I500369Medicare PIN
AL510I500373Medicare PIN