MEDICARE: VANESSA JONES FNP

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	1-087943	AL

General Provider Information

NPI Number	:	1609400621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA JONES FNP

Provider Business Mailing Address
First Line	:	204 VANCOUVER CT
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35211-6929
Country	:	US
Telephone Number	:	205-739-9397
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 VANCOUVER CT
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35211-6929
Country	:	US
Telephone Number	:	205-739-9397
Fax Number	:

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

Provider Enumeration Date	:	02/28/2020
Last Update Date	:	02/28/2020

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