Basic Information
Provider Information
NPI: 1003297342
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: ANISHA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: MSN, MPH, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 600 HOSPITAL DR
Address2:  
City: MONROE
State: NC
PostalCode: 281126000
CountryCode: US
TelephoneNumber: 7045125363
FaxNumber:  
Practice Location
Address1: 1500 MATTHEWS TOWNSHIP PKWY
Address2:  
City: MATTHEWS
State: NC
PostalCode: 281054656
CountryCode: US
TelephoneNumber: 7043846478
FaxNumber: 7043848182
Other Information
ProviderEnumerationDate: 06/12/2015
LastUpdateDate: 10/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X243623NCN Nursing Service ProvidersRegistered Nurse 
363L00000X5007782NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363L00000X243623NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

ID Information
IDTypeStateIssuerDescription
NP334805SC MEDICAID
100329734205NC MEDICAID


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