Basic Information
| Provider Information | |||||||||
| NPI: | 1003297342 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | ANISHA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSN, MPH, FNP-C | ||||||||
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| 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 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 243623 | NC | N | Nursing Service Providers | Registered Nurse | 363L00000X | 243623 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 5007782 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 1003297342 | 05 | NC | MEDICAID | NP3348 | 05 | SC | MEDICAID |