Provider Demographics
NPI:1053536680
Name:JONES, LOUISE A (ANP-BC)
Entity type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:LOUISE
Other - Middle Name:ANN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:22978 HOMESTEAD LANDING CT
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-1772
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19450 DEERFIELD AVE STE 325
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8503
Practice Address - Country:US
Practice Address - Phone:571-252-8119
Practice Address - Fax:800-735-1643
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165407363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1053536680Medicaid