Healthcare Provider Details

I. General information

NPI: 1568724011
Provider Name (Legal Business Name): KATE JONES SHARE M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 N HURON ST
YPSILANTI MI
48197-2607
US

IV. Provider business mailing address

47 N HURON ST
YPSILANTI MI
48197-2607
US

V. Phone/Fax

Practice location:
  • Phone: 734-484-3600
  • Fax: 734-484-3100
Mailing address:
  • Phone: 734-484-3600
  • Fax: 734-484-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: