Provider Demographics
NPI:1548638877
Name:JONES, CAROLYN J (FNP-BC)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:J
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:215 N COLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-3530
Mailing Address - Country:US
Mailing Address - Phone:478-237-2638
Mailing Address - Fax:478-237-9138
Practice Address - Street 1:1636 HATCH PKWY S
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-4376
Practice Address - Country:US
Practice Address - Phone:912-705-5656
Practice Address - Fax:912-705-5652
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN146779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I504108Medicare PIN