MEDICARE: STEPHANIE MARIE JONES FNP

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	363LF0000X	Family Nurse Practitioner	5006771	NC
2	363L00000X	Nurse Practitioner	330955	AZ
3	363L00000X	Nurse Practitioner	5006771	NC

General Provider Information

NPI Number	:	1740605666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MARIE JONES FNP

Provider Business Mailing Address
First Line	:	PO BOX 19305
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28219-9305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1021 MOREHEAD MEDICAL DR
Second Line	:	STE A
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2990
Country	:	US
Telephone Number	:	980-442-2000
Fax Number	:

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

Provider Enumeration Date	:	02/28/2014
Last Update Date	:	12/23/2025

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