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General NPI Number Information
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NPI Number | 1912259037
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Entity Type | Individual
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Provider Name | MICHAEL JONES RN
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Gender | Male
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Dates
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Enumeration Date | 10/12/2012
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Last Update Date | 01/14/2014
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Provider Practice Location Address
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Address Line | 1322 WASHINGTON STREET NORTH
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City | NORTH TWIN FALLS
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State | ID
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Zip | 83301-9036
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Country | US
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Telephone | 208-733-0740
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Fax |
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Provider Business Mailing Address
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Address Line | 1322 WASHINGTON STREET
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City | NORTH TWIN FALLS
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State | ID
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Zip | 83301
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number | 4578962
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License Number State | ID
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