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NPI Code Detail

MEDICARE: ELLIE JONES

MEDICARE: ELLIE JONES
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
1363AM0700XMedical Physician AssistantPA.0008339CO
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1376192310
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLIE JONES
Provider Business Mailing Address
First Line : PO BOX 800022
Second Line :
City : KANSAS CITY
State : MO
Zip : 64180-0022
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6001 E WOODMEN RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80923-2601
Country : US
Telephone Number : 719-571-3755
Fax Number : 719-571-8410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2019
Last Update Date : 01/08/2026

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Directions to “ ELLIE JONES ” Practice Location

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