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General NPI Number Information
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NPI Number | 1699529107
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE JONES DNP-FNP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2024
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 381 S MIDDLETON RD STE B
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City | MIDDLETON
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State | ID
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Zip | 83644-5369
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Country | US
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Telephone | 208-585-6311
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Fax | 208-585-6221
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Provider Business Mailing Address
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Address Line | PO BOX 277976
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City | ATLANTA
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State | GA
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Zip | 30384-6035
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4161676
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License Number State | ID
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