MEDICARE: MS. MARY I JONES FNP-C

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	RN047344	GA

General Provider Information

NPI Number	:	1508823584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY I JONES FNP-C

Provider Business Mailing Address
First Line	:	5665 PEACHTREE DUNWOODY RD NE
Second Line	:	SUITE 172
City	:	ATLANTA
State	:	GA
Zip	:	30342-1701
Country	:	US
Telephone Number	:	404-851-5400
Fax Number	:	404-851-5401

Provider Business Practice Location Address
First Line	:	5665 PEACHTREE DUNWOODY RD NE
Second Line	:	SUITE 172
City	:	ATLANTA
State	:	GA
Zip	:	30342-1701
Country	:	US
Telephone Number	:	404-851-5400
Fax Number	:	404-851-5401

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	07/08/2007

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