MEDICARE: KATIE JONES FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN29302	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104808096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE JONES FNP

Provider Business Mailing Address
First Line	:	PO BOX 40000
Second Line	:
City	:	VAIL
State	:	CO
Zip	:	81658-7520
Country	:	US
Telephone Number	:	970-476-2451
Fax Number	:

Provider Business Practice Location Address
First Line	:	322 BEARD CREEK RD
Second Line	:
City	:	EDWARDS
State	:	CO
Zip	:	81632-6433
Country	:	US
Telephone Number	:	970-476-2451
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	11/12/2021

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