Provider Demographics
NPI:1841886710
Name:JONES, THEODOSIA MARIA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:THEODOSIA
Middle Name:MARIA
Last Name:JONES
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2216
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-8443
Mailing Address - Country:US
Mailing Address - Phone:804-922-9079
Mailing Address - Fax:888-435-2131
Practice Address - Street 1:10725 ETHENS MILL RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1497
Practice Address - Country:US
Practice Address - Phone:804-922-9079
Practice Address - Fax:888-435-2131
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001230093163WA2000X, 163WC0400X, 163WC1500X, 163WD1100X, 163WG0000X, 163WH0200X, 163WH0500X, 163WM0705X, 163WP0808X, 163W00000X
VA00012300933163WN0300X
VA0002075277164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WN0300XNursing Service ProvidersRegistered NurseNephrology
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse