Healthcare Provider Details

I. General information

NPI: 1053222877
Provider Name (Legal Business Name): COURTNEY PAIGE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 WINDING WOODS DR
O FALLON MO
63366-4771
US

IV. Provider business mailing address

300 WINDING WOODS DR
O FALLON MO
63366-4771
US

V. Phone/Fax

Practice location:
  • Phone: 636-614-3280
  • Fax:
Mailing address:
  • Phone: 636-614-3280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2019023972
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: