Healthcare Provider Details

I. General information

NPI: 1063757144
Provider Name (Legal Business Name): KRISTINA A JONES-PARKER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2012
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 DUBLIN SQUARE RD STE B
ASHEBORO NC
27203-8601
US

IV. Provider business mailing address

PO BOX 746724
ATLANTA GA
30374-6724
US

V. Phone/Fax

Practice location:
  • Phone: 336-610-1300
  • Fax:
Mailing address:
  • Phone: 773-644-3941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5012900
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number659259
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: