Healthcare Provider Details

I. General information

NPI: 1376466375
Provider Name (Legal Business Name): KAITLYN JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 J CLYDE MORRIS BLVD
NEWPORT NEWS VA
23601-1929
US

IV. Provider business mailing address

1464 E INTRUDER CIR
VIRGINIA BEACH VA
23454-5412
US

V. Phone/Fax

Practice location:
  • Phone: 757-594-2000
  • Fax:
Mailing address:
  • Phone: 724-708-6402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: