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NPI Code Detail

MEDICARE: TERRI C JONES PA

MEDICARE: TERRI C JONES PA
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
1363A00000XPhysician AssistantPA274ID

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00160001OTHERIDRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000010148334OTHERIDBCBS
2PANW3OTHERIDBCBS
4PANV5OTHERIDBCBS
5000010148335OTHERIDBCBS

General Provider Information

NPI Number : 1336138361
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRI C JONES PA
Provider Business Mailing Address
First Line : 217 W GEORGIA AVE
Second Line :
City : NAMPA
State : ID
Zip : 83686-6811
Country : US
Telephone Number : 208-463-3000
Fax Number : 208-463-3034
Provider Business Practice Location Address
First Line : 215 E HAWAII AVE
Second Line :
City : NAMPA
State : ID
Zip : 83686-6011
Country : US
Telephone Number : 208-463-3000
Fax Number : 208-463-3034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 07/08/2007

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Directions to “ TERRI C JONES PA” Practice Location

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