Provider Demographics
NPI:1235281841
Name:JONES, JOCQUELIN V (NP)
Entity type:Individual
Prefix:MS
First Name:JOCQUELIN
Middle Name:V
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9676 SW GLENBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2405
Mailing Address - Country:US
Mailing Address - Phone:856-524-2815
Mailing Address - Fax:
Practice Address - Street 1:9676 SW GLENBROOK DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-2405
Practice Address - Country:US
Practice Address - Phone:856-524-2815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9365725363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care