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NPI Code Detail

MEDICARE: KEIANA JONES

MEDICARE: KEIANA 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
1101Y00000XCounselor1451MS

General Provider Information

NPI Number : 1568796738
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEIANA JONES
Provider Business Mailing Address
First Line : PO BOX 1505
Second Line :
City : GREENWOOD
State : MS
Zip : 38935-1505
Country : US
Telephone Number : 662-453-6211
Fax Number :
Provider Business Practice Location Address
First Line : 2504 BROWNING ROAD 520
Second Line :
City : GREENWOOD
State : MS
Zip : 38930-6022
Country : US
Telephone Number : 662-453-6211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2009
Last Update Date : 08/23/2017

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Directions to “ KEIANA JONES ” Practice Location

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