Provider Demographics
NPI:1114778545
Name:JONES, SHARON ANN (CTRI, ESMHL)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:CTRI, ESMHL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55524 BUCKNELL ROAD
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:MI
Mailing Address - Zip Code:49072
Mailing Address - Country:US
Mailing Address - Phone:269-873-1214
Mailing Address - Fax:
Practice Address - Street 1:55524 BUCKNELL ROAD
Practice Address - Street 2:
Practice Address - City:MENDON
Practice Address - State:MI
Practice Address - Zip Code:49072
Practice Address - Country:US
Practice Address - Phone:269-873-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker