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General NPI Number Information
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NPI Number | 1164545208
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Entity Type | Individual
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Provider Name | MRS. JUDITH MAE JONES
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 415 WATER ST
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City | ELLSWORTH
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State | ME
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Zip | 04605-2116
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Country | US
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Telephone | 207-667-5357
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Fax | 207-667-0174
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Provider Business Mailing Address
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Address Line | 358 MAIN RD S
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City | HAMPDEN
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State | ME
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Zip | 04444-1103
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Country | US
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Telephone | 207-862-4560
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R038862
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License Number State | ME
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