MEDICARE: AQUINTAS CHAVETTE JONES LPN

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	164W00000X	Licensed Practical Nurse	0002105868	VA

General Provider Information

NPI Number	:	1568309235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AQUINTAS CHAVETTE JONES LPN

Provider Business Mailing Address
First Line	:	1412 OAKDALE AVE
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-3915
Country	:	US
Telephone Number	:	678-557-5908
Fax Number	:	804-203-1657

Provider Business Practice Location Address
First Line	:	1412 OAKDALE AVE
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-3915
Country	:	US
Telephone Number	:	678-557-5908
Fax Number	:	804-203-1657

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

Provider Enumeration Date	:	04/30/2026
Last Update Date	:	04/30/2026

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