MEDICARE: JOAN MARIE MCNAB JONES NP

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	R0980625	MN

General Provider Information

NPI Number	:	1831165927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN MARIE MCNAB JONES NP

Provider Business Mailing Address
First Line	:	388 NOTTINGHAM DR
Second Line	:
City	:	CIRCLE PINES
State	:	MN
Zip	:	55014-1718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2849 JOHNSON ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-3055
Country	:	US
Telephone Number	:	612-706-4500
Fax Number	:

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	02/26/2008

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