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NPI Code Detail

MEDICARE: TACOYA JONES NP

MEDICARE:   TACOYA  JONES  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner4704268616MI

General Provider Information

NPI Number : 1326550443
Entity Type Code : Individual
Provider Name (Legal Business Name) : TACOYA JONES NP
Provider Business Mailing Address
First Line : 3300 WASHTENAW AVE STE 280
Second Line :
City : ANN ARBOR
State : MI
Zip : 48104-5184
Country : US
Telephone Number : 855-659-7734
Fax Number :
Provider Business Practice Location Address
First Line : 2785 E GRAND BLVD
Second Line :
City : DETROIT
State : MI
Zip : 48211-2003
Country : US
Telephone Number : 915-900-3612
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2017
Last Update Date : 01/18/2023

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