Provider Demographics
NPI:1487270450
Name:JONES, COURTNEY BAILEY (AGACNP-BC)
Entity type:Individual
Prefix:MR
First Name:COURTNEY
Middle Name:BAILEY
Last Name:JONES
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 LEGRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23923-3747
Mailing Address - Country:US
Mailing Address - Phone:434-542-5560
Mailing Address - Fax:
Practice Address - Street 1:165 LEGRANDE AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE COURT HOUSE
Practice Address - State:VA
Practice Address - Zip Code:23923-3747
Practice Address - Country:US
Practice Address - Phone:434-542-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024179538363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care