Healthcare Provider Details

I. General information

NPI: 1073510392
Provider Name (Legal Business Name): ANN L. JONES A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 HARRODSBURG RD C100
LEXINGTON KY
40504-3751
US

IV. Provider business mailing address

1401 HARRODSBURG RD C100
LEXINGTON KY
40504-3751
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-4960
  • Fax: 859-278-0033
Mailing address:
  • Phone: 859-278-4960
  • Fax: 859-278-0033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1778P
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number1778S
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1033529
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: