Basic Information
Provider Information
NPI: 1093110322
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: WENDY
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 119 HENDERSONVILLE RD
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288032868
CountryCode: US
TelephoneNumber: 8287715500
FaxNumber: 8282574750
Practice Location
Address1: 119 HENDERSONVILLE RD
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288032868
CountryCode: US
TelephoneNumber: 8287715500
FaxNumber: 8282574750
Other Information
ProviderEnumerationDate: 10/29/2014
LastUpdateDate: 03/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X320368NCN Nursing Service ProvidersRegistered Nurse 
367A00000X749NCY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

ID Information
IDTypeStateIssuerDescription
Q66625A01NCPTANOTHER


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