MEDICARE: MRS. CHERYL E JONES CNP

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	RN627798	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN627798	OTHER		CRNP LICENSE

General Provider Information

NPI Number	:	1437145752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL E JONES CNP

Provider Business Mailing Address
First Line	:	1331 E WYOMING AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-3808
Country	:	US
Telephone Number	:	215-537-7400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1331 E WYOMING AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-3808
Country	:	US
Telephone Number	:	215-537-7400
Fax Number	:

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	02/23/2015

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