MEDICARE: MS. MARIA JONES APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	4567P	KY
2	363LP0200X	Pediatric Nurse Practitioner	3004567	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	000000492591	OTHER	BC BS APC
2	000000363979	OTHER	BC BS HHC
3	7706646	OTHER	AETNA HHC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194793760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA JONES APRN

Provider Business Mailing Address
First Line	:	496 SOUTHLAND DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-1827
Country	:	US
Telephone Number	:	859-288-2392
Fax Number	:	859-721-3918

Provider Business Practice Location Address
First Line	:	551 PARKSIDE DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505-1726
Country	:	US
Telephone Number	:	859-288-2425
Fax Number	:	859-721-3918

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	05/22/2019

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