Healthcare Provider Details

I. General information

NPI: 1841886710
Provider Name (Legal Business Name): THEODOSIA MARIA JONES REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10725 ETHENS MILL RD
CHESTER VA
23831-1497
US

IV. Provider business mailing address

PO BOX 2216
CHESTER VA
23831-8443
US

V. Phone/Fax

Practice location:
  • Phone: 804-922-9079
  • Fax: 888-435-2131
Mailing address:
  • Phone: 804-922-9079
  • Fax: 888-435-2131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number0001230093
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number0001230093
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number0001230093
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code163WD1100X
TaxonomyPeritoneal Dialysis Registered Nurse
License Number0001230093
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number0001230093
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number0001230093
License Number StateVA
# 7
Primary TaxonomyN
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number0001230093
License Number StateVA
# 8
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number0001230093
License Number StateVA
# 9
Primary TaxonomyN
Taxonomy Code163WN0300X
TaxonomyNephrology Registered Nurse
License Number00012300933
License Number StateVA
# 10
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number0001230093
License Number StateVA
# 11
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number0002075277
License Number StateVA
# 12
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001230093
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: