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General NPI Number Information
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NPI Number | 1386352698
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Entity Type | Individual
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Provider Name | RAVEN JONES FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 5601 ARRINGDON PARK DR STE 420
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City | MORRISVILLE
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State | NC
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Zip | 27560-5676
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Country | US
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Telephone | 919-997-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 143 SONGBIRD LN
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City | FARMINGTON
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State | CT
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Zip | 06032-3433
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Country | US
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Telephone | 203-752-8225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5017193
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License Number State | NC
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