Provider Demographics
NPI:1033638291
Name:JONES, KATY JEAN (CNP)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:JEAN
Last Name:JONES
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 NORTH MAIN
Mailing Address - Street 2:ATTN: AUDRA NELSON-BAILEY
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783
Mailing Address - Country:US
Mailing Address - Phone:605-644-4431
Mailing Address - Fax:
Practice Address - Street 1:1445 NORTH AVE
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1552
Practice Address - Country:US
Practice Address - Phone:605-644-4170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP001270363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily