Healthcare Provider Details

I. General information

NPI: 1750662367
Provider Name (Legal Business Name): RICHARD SUMMERS JONES FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 PINNELL ST
RIPLEY WV
25271-9101
US

IV. Provider business mailing address

122 PINNELL ST
RIPLEY WV
25271-9101
US

V. Phone/Fax

Practice location:
  • Phone: 304-373-1578
  • Fax: 304-373-0497
Mailing address:
  • Phone: 304-373-1578
  • Fax: 304-373-0497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number52870
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number827
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: