MEDICARE: MRS. MARIE W JONES WHNP

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	363LW0102X	Women's Health Nurse Practitioner	RN028735	GA

General Provider Information

NPI Number	:	1700944592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIE W JONES WHNP

Provider Business Mailing Address
First Line	:	P O BOX R
Second Line	:
City	:	ARLINGTON
State	:	GA
Zip	:	39813
Country	:	US
Telephone Number	:	229-725-2147
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 RE JENNINGS AVE SE
Second Line	:
City	:	ARLINGTON
State	:	GA
Zip	:	39813-8725
Country	:	US
Telephone Number	:	229-725-4251
Fax Number	:	229-725-2212

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	09/06/2011

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