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NPI Code Detail

MEDICARE: MS. KIMBERLY S JONES RN

MEDICARE: MS. KIMBERLY S JONES RN
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
1163WR0006XRegistered Nurse First Assistant041.248544IL

General Provider Information

NPI Number : 1336376433
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLY S JONES RN
Provider Business Mailing Address
First Line : 500 CRESTMORE AVE
Second Line :
City : MATTOON
State : IL
Zip : 61938-4622
Country : US
Telephone Number : 217-234-3750
Fax Number :
Provider Business Practice Location Address
First Line : 103 PROFESSIONAL PLZ
Second Line :
City : MATTOON
State : IL
Zip : 61938-9252
Country : US
Telephone Number : 217-348-1030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2009
Last Update Date : 06/16/2009

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