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NPI Code Detail

MEDICARE: TARA JONES

MEDICARE: TARA JONES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1174487680
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA JONES
Provider Business Mailing Address
First Line : 205 W PINON AVE
Second Line :
City : BLOOMFIELD
State : NM
Zip : 87413-5964
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1009 RIDGEWAY PL
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-2092
Country : US
Telephone Number : 505-402-6886
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 06/08/2026

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Directions to “ TARA JONES ” Practice Location

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