MEDICARE: JESSICA L 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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1710494224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA L JONES

Provider Business Mailing Address
First Line	:	396 COUNTRY RUN CIR
Second Line	:
City	:	POWELL
State	:	TN
Zip	:	37849-5426
Country	:	US
Telephone Number	:	865-228-1037
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 SAVANNAH LN
Second Line	:
City	:	ROCKY TOP
State	:	TN
Zip	:	37769-5207
Country	:	US
Telephone Number	:	865-228-1037
Fax Number	:

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

Provider Enumeration Date	:	01/05/2018
Last Update Date	:	07/18/2024

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