Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 42519 | NE |
NPI | 1023082443 |
---|---|
Provider Name | Patricia Joanne Jones |
First Address | Panama City, FL 32403-1244 |
Second Address | Tyndall A F B, FL 32403-5604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 08/07/2007 |