MEDICARE: AMY NICOLE JONES PNP

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	363LP0200X	Pediatric Nurse Practitioner	53-75276-111	KS
2	363LP0200X	Pediatric Nurse Practitioner	2010022940	MO

General Provider Information

NPI Number	:	1306952551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY NICOLE JONES PNP

Provider Business Mailing Address
First Line	:	4306 W 82ND TER
Second Line	:
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-5039
Country	:	US
Telephone Number	:	816-872-2757
Fax Number	:

Provider Business Practice Location Address
First Line	:	4306 W 82ND TER
Second Line	:
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-5039
Country	:	US
Telephone Number	:	816-872-2757
Fax Number	:

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	02/05/2025

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