Healthcare Provider Details

I. General information

NPI: 1144808833
Provider Name (Legal Business Name): ROBIN LEE JONES PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BOULDERS PKWY STE 202
NORTH CHESTERFIELD VA
23225-5515
US

IV. Provider business mailing address

1000 BOULDERS PKWY STE 202
NORTH CHESTERFIELD VA
23225-5515
US

V. Phone/Fax

Practice location:
  • Phone: 801-320-7881
  • Fax: 804-320-2050
Mailing address:
  • Phone: 804-212-2450
  • Fax: 804-320-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024180660
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: