Provider Demographics
NPI:1093585028
Name:JONES, AMBER (CHW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 E PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-8990
Mailing Address - Country:US
Mailing Address - Phone:989-773-5921
Mailing Address - Fax:
Practice Address - Street 1:2012 E PRESTON ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-8990
Practice Address - Country:US
Practice Address - Phone:989-773-5921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1245283977Medicaid