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General NPI Number Information
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NPI Number | 1467910422
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Entity Type | Individual
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Provider Name | DEWINA JONES
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Gender | Female
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Dates
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Enumeration Date | 03/08/2019
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Last Update Date | 03/08/2019
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Provider Practice Location Address
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Address Line | 411 NEW LIBERTY CHURCH RD LOT 5
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City | BRASELTON
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State | GA
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Zip | 30517-1871
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Country | US
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Telephone | 678-837-8287
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Fax |
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Provider Business Mailing Address
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Address Line | 411 NEW LIBERTY CHURCH RD LOT 5
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City | BRASELTON
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State | GA
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Zip | 30517-1871
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Country | US
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Telephone |
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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