Healthcare Provider Details

I. General information

NPI: 1285751628
Provider Name (Legal Business Name): MRS. DONNA MARIE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 LONGVIEW AVE
WEST PORTSMOUTH OH
45663-5929
US

IV. Provider business mailing address

1116 LONGVIEW AVE
WEST PORTSMOUTH OH
45663-5929
US

V. Phone/Fax

Practice location:
  • Phone: 740-858-1324
  • Fax: 740-858-1324
Mailing address:
  • Phone: 740-858-1324
  • Fax: 740-858-1324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberT1019
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: