Individual
KATHY JO JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(800) 476-8646
(919) 382-3210
Mailing address
556 SANDHURST DR, FAYETTEVILLE, NC 28304-4426
(910) 483-2646
(910) 483-9470
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02140
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-02140
NC MEDICAL LICENSE
NC
Enumeration date
03/04/2010
Last updated
07/25/2012
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