MEDICARE: MS. ELLEN DAVIS 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	201953	NC

General Provider Information

NPI Number	:	1306163118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELLEN DAVIS JONES FNP

Provider Business Mailing Address
First Line	:	502 W PARKWAY AVE
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27262-3032
Country	:	US
Telephone Number	:	336-887-4134
Fax Number	:

Provider Business Practice Location Address
First Line	:	502 W PARKWAY AVE
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27262-3032
Country	:	US
Telephone Number	:	336-887-4134
Fax Number	:

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

Provider Enumeration Date	:	05/03/2010
Last Update Date	:	05/03/2010

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