MEDICARE: KAREN LUCY JONES PA-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	363A00000X	Physician Assistant	14148	MN
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1679220214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LUCY JONES PA-C

Provider Business Mailing Address
First Line	:	1001 E CENTRAL ENTRANCE STE 200
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55811-5525
Country	:	US
Telephone Number	:	218-722-0833
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 E CENTRAL ENTRANCE STE 200
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55811-5525
Country	:	US
Telephone Number	:	218-722-0833
Fax Number	:

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

Provider Enumeration Date	:	03/03/2022
Last Update Date	:	02/05/2026

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