MEDICARE: MRS. SHARON SUE 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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1861668329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON SUE JONES

Provider Business Mailing Address
First Line	:	2774 N BEACON HILL CT
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-4220
Country	:	US
Telephone Number	:	316-771-7335
Fax Number	:	316-771-7201

Provider Business Practice Location Address
First Line	:	4031 E HARRY ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67218-3724
Country	:	US
Telephone Number	:	316-771-7335
Fax Number	:	316-771-7201

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

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	05/05/2008

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