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General NPI Number Information
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NPI Number | 1770830150
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Entity Type | Individual
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Provider Name | MARY ELIZABETH JONES
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Gender | Female
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Dates
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Enumeration Date | 08/05/2012
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Last Update Date | 08/05/2012
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Provider Practice Location Address
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Address Line | 344 E 100 S STE 301
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City | SALT LAKE CITY
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State | UT
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Zip | 84111-1727
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Country | US
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Telephone | 801-322-4257
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Fax |
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Provider Business Mailing Address
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Address Line | 3958 LISHAWN DR
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City | TAYLORSVILLE
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State | UT
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Zip | 84129-8116
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Country | US
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Telephone | 801-664-3793
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 178820912
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License Number State | UT
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