MEDICARE: DENISE RENEE JONES LVN

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	183700000X	Pharmacy Technician	266535	TX
2	347C00000X	Private Vehicle
3	164X00000X	Licensed Vocational Nurse	1013030	TX

General Provider Information

NPI Number	:	1356935498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE RENEE JONES LVN

Provider Business Mailing Address
First Line	:	523 COCHRAN DR
Second Line	:
City	:	PRINCETON
State	:	TX
Zip	:	75407-5692
Country	:	US
Telephone Number	:	816-405-1769
Fax Number	:

Provider Business Practice Location Address
First Line	:	523 COCHRAN DR
Second Line	:
City	:	PRINCETON
State	:	TX
Zip	:	75407-5692
Country	:	US
Telephone Number	:	816-405-1769
Fax Number	:

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

Provider Enumeration Date	:	03/01/2021
Last Update Date	:	04/25/2023

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