MEDICARE: ELIZABETH ERIN 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	163W00000X	Registered Nurse	2004005156	MO
2	363LF0000X	Family Nurse Practitioner	2024027175	MO

General Provider Information

NPI Number	:	1790528289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ERIN JONES FNP

Provider Business Mailing Address
First Line	:	1554 PROSPECT LAKES DR
Second Line	:
City	:	WENTZVILLE
State	:	MO
Zip	:	63385-4905
Country	:	US
Telephone Number	:	636-614-8121
Fax Number	:

Provider Business Practice Location Address
First Line	:	774 GRAVOIS BLUFFS BLVD STE A
Second Line	:
City	:	FENTON
State	:	MO
Zip	:	63026-7758
Country	:	US
Telephone Number	:	636-343-5223
Fax Number	:

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

Provider Enumeration Date	:	06/13/2024
Last Update Date	:	07/04/2025

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