MEDICARE: MS. RAVEN SHARIE JONES FNP-BC

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	363L00000X	Nurse Practitioner	5017193	NC

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

General Provider Information

NPI Number	:	1386352698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RAVEN SHARIE JONES FNP-BC

Provider Business Mailing Address
First Line	:	143 SONGBIRD LN
Second Line	:
City	:	FARMINGTON
State	:	CT
Zip	:	06032-3433
Country	:	US
Telephone Number	:	203-752-8225
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 ARRINGDON PARK DR STE 420
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-5676
Country	:	US
Telephone Number	:	919-997-3000
Fax Number	:

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

Provider Enumeration Date	:	11/07/2022
Last Update Date	:	05/26/2026

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