Healthcare Provider Details

I. General information

NPI: 1962055418
Provider Name (Legal Business Name): CHARLAMY MEGAN JONES MSN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2019
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 W MILLBROOK RD STE 210
RALEIGH NC
27609-4490
US

IV. Provider business mailing address

PO BOX 98673
RALEIGH NC
27624-8673
US

V. Phone/Fax

Practice location:
  • Phone: 919-410-8560
  • Fax: 605-309-7805
Mailing address:
  • Phone: 919-841-2357
  • Fax: 605-309-7805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAG05190092
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: