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NPI Code Detail

MEDICARE: CARLYN AURELIA JONES

MEDICARE: CARLYN AURELIA JONES
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
1224Y00000XClinical Exercise Physiologist
2363A00000XPhysician Assistant0110007905VA

General Provider Information

NPI Number : 1417381161
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLYN AURELIA JONES
Provider Business Mailing Address
First Line : 5460 WESLEYAN DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455-6906
Country : US
Telephone Number : 757-395-1900
Fax Number : 757-995-7373
Provider Business Practice Location Address
First Line : 5460 WESLEYAN DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455-6906
Country : US
Telephone Number : 757-395-1900
Fax Number : 757-995-7373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2013
Last Update Date : 09/04/2024

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Directions to “ CARLYN AURELIA JONES ” Practice Location

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