Provider Demographics
NPI:1003476219
Name:JONES, DEBRA SPICELY
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:SPICELY
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAYDEN DR PO BOX 9081
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23806-0001
Mailing Address - Country:US
Mailing Address - Phone:804-524-5847
Mailing Address - Fax:
Practice Address - Street 1:1 HAYDEN DR
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-2520
Practice Address - Country:US
Practice Address - Phone:804-524-5847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator