MEDICARE: ASHLEY JONES NURSE PRACTITIONER

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	163WP0200X	Pediatric Registered Nurse	285472	GA
2	363LP0200X	Pediatric Nurse Practitioner	0000000000	GA

General Provider Information

NPI Number	:	1932968278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY JONES NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	150 EARLY STREET EXT
Second Line	:
City	:	SPRINGFIELD
State	:	GA
Zip	:	31329
Country	:	US
Telephone Number	:	954-249-0925
Fax Number	:

Provider Business Practice Location Address
First Line	:	1497 FAIR RD STE 204
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30458-0824
Country	:	US
Telephone Number	:	954-249-0925
Fax Number	:

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

Provider Enumeration Date	:	03/18/2024
Last Update Date	:	07/09/2025

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