Provider Demographics
NPI:1952716417
Name:JONES, FELICIA MOODY (FNP)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:MOODY
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4714 MARSHALL AVE
Mailing Address - Street 2:48TH STREET PHYSICIANS
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23607
Mailing Address - Country:US
Mailing Address - Phone:757-380-8709
Mailing Address - Fax:757-952-1345
Practice Address - Street 1:4714 MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23607-2247
Practice Address - Country:US
Practice Address - Phone:757-380-8709
Practice Address - Fax:757-952-1345
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily