Healthcare Provider Details

I. General information

NPI: 1710655352
Provider Name (Legal Business Name): PAIGE MICHELLE JONES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 MAIN ST
SIDNEY IA
51652-8036
US

IV. Provider business mailing address

1219 MAIN ST
HAMBURG IA
51640-1300
US

V. Phone/Fax

Practice location:
  • Phone: 712-374-2649
  • Fax:
Mailing address:
  • Phone: 712-382-2626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA164474
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number140523
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: