Healthcare Provider Details

I. General information

NPI: 1831497494
Provider Name (Legal Business Name): CECELIA ANN JONES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CECELIA ANN GRANT PA-C

II. Dates (important events)

Enumeration Date: 03/07/2011
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 160
NENANA AK
99760-0160
US

IV. Provider business mailing address

200 1ST AVE
FAIRBANKS AK
99701-4805
US

V. Phone/Fax

Practice location:
  • Phone: 907-452-8251
  • Fax:
Mailing address:
  • Phone: 907-452-8251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number976
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: