MEDICARE: DEBORAH LYNN 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
1	385H00000X	Respite Care

General Provider Information

NPI Number	:	1184210007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH LYNN JONES

Provider Business Mailing Address
First Line	:	2907 S SR 134 LOT 4
Second Line	:
City	:	WILMINGTON
State	:	OH
Zip	:	45177-9710
Country	:	US
Telephone Number	:	937-728-6303
Fax Number	:

Provider Business Practice Location Address
First Line	:	2907 S SR 134 LOT 4
Second Line	:
City	:	WILMINGTON
State	:	OH
Zip	:	45177-9710
Country	:	US
Telephone Number	:	937-728-6303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2020
Last Update Date	:	12/15/2020

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Directions to “ DEBORAH LYNN JONES ” Practice Location

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