Healthcare Provider Details

I. General information

NPI: 1689500803
Provider Name (Legal Business Name): MIA' JONES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 RESERVOIR RD NW
WASHINGTON DC
20007-2111
US

IV. Provider business mailing address

103 CRESTVIEW DR
FARMVILLE VA
23901-2367
US

V. Phone/Fax

Practice location:
  • Phone: 804-385-4784
  • Fax:
Mailing address:
  • Phone: 804-385-4784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number0001303092
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: