MEDICARE: DAWN M JONES LPN

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	164W00000X	Licensed Practical Nurse	308097-31	WI

General Provider Information

NPI Number	:	1467696179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN M JONES LPN

Provider Business Mailing Address
First Line	:	3046 S 47TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53219-3434
Country	:	US
Telephone Number	:	414-940-0775
Fax Number	:	414-921-1820

Provider Business Practice Location Address
First Line	:	3046 S 47TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53219-3434
Country	:	US
Telephone Number	:	414-940-0775
Fax Number	:	414-921-1820

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

Provider Enumeration Date	:	04/24/2009
Last Update Date	:	04/24/2009

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