Healthcare Provider Details
I. General information
NPI: 1609791409
Provider Name (Legal Business Name): CHRISTY JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
261 MONTGOMERY DR
STOCKBRIDGE GA
30281-2839
US
IV. Provider business mailing address
261 MONTGOMERY DR
STOCKBRIDGE GA
30281-2839
US
V. Phone/Fax
- Phone: 847-252-1258
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN230564 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: