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General NPI Number Information
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NPI Number | 1679595052
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Entity Type | Individual
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Provider Name | VICTORIA LEA JONES PA
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Gender | Female
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 875 E MAIN ST
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City | WACONIA
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State | MN
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Zip | 55387-1081
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Country | US
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Telephone | 952-442-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 8024 AUTUMN RIDGE WAY
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City | CHANHASSEN
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State | MN
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Zip | 55317-8449
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 8802
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License Number State | MN
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