Provider Demographics
NPI:1932357324
Name:JONES, MARCIA LEE (NP)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:LEE
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:L
Other - Last Name:KESNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:SPRINGFIELD PIKE
Mailing Address - Street 2:PO BOX 84
Mailing Address - City:SPRINGFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26763-0000
Mailing Address - Country:US
Mailing Address - Phone:304-822-2500
Mailing Address - Fax:304-822-2506
Practice Address - Street 1:214 PACA ST STE A
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2844
Practice Address - Country:US
Practice Address - Phone:240-362-7557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167948363LF0000X
MDR158658363L00000X
WV55323363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810020900Medicaid
VA0024167948OtherVA LICENSE
WV3810020900Medicaid