Provider Demographics
NPI:1679273130
Name:JONES, JULIA ELIZABETH (CNP-FAMILY)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ELIZABETH
Last Name:JONES
Suffix:
Gender:F
Credentials:CNP-FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4261 N 495 RD
Mailing Address - Street 2:
Mailing Address - City:ROSE
Mailing Address - State:OK
Mailing Address - Zip Code:74364-2194
Mailing Address - Country:US
Mailing Address - Phone:830-515-6622
Mailing Address - Fax:
Practice Address - Street 1:1635 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-5368
Practice Address - Country:US
Practice Address - Phone:830-515-6622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK210785363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily