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General NPI Number Information
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NPI Number | 1750035671
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Entity Type | Individual
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Provider Name | GINELLE STEVENS JONES FNP
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Gender | Female
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Dates
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Enumeration Date | 02/09/2022
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 1340 STATE ROUTE 9
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City | LAKE GEORGE
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State | NY
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Zip | 12845-3484
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Country | US
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Telephone | 518-761-6580
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Fax | 518-761-6422
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Provider Business Mailing Address
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Address Line | 1340 STATE ROUTE 9
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City | LAKE GEORGE
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State | NY
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Zip | 12845-3484
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Country | US
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Telephone | 518-761-6580
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Fax | 518-761-6422
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 462543
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License Number State | NY
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