Healthcare Provider Details

I. General information

NPI: 1629995741
Provider Name (Legal Business Name): JOSALYNN JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 W SYCAMORE ST
WILLIAMSBURG KY
40769-1739
US

IV. Provider business mailing address

606 OLD CORBIN PIKE RD
WILLIAMSBURG KY
40769-2108
US

V. Phone/Fax

Practice location:
  • Phone: 606-400-6362
  • Fax:
Mailing address:
  • Phone: 606-304-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4053682
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: