Healthcare Provider Details

I. General information

NPI: 1255934568
Provider Name (Legal Business Name): TONYA YVONNE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5211 US 90 C
PACE FL
32571
US

IV. Provider business mailing address

354 MILL ST
HAGERSTOWN MD
21740-6138
US

V. Phone/Fax

Practice location:
  • Phone: 407-268-0011
  • Fax:
Mailing address:
  • Phone: 301-797-0210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11040850
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: