Healthcare Provider Details

I. General information

NPI: 1952182784
Provider Name (Legal Business Name): FAITH V JONES AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4233 CAMELOT CROSSING
VALDOSTA GA
31602-6926
US

IV. Provider business mailing address

4233 CAMELOT CROSSING
VALDOSTA GA
31602-6926
US

V. Phone/Fax

Practice location:
  • Phone: 229-469-4383
  • Fax: 229-469-4584
Mailing address:
  • Phone: 229-469-4383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN292480
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: