Provider Demographics
NPI:1164545208
Name:JONES, JUDITH MAE
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:MAE
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 1:358 MAIN RD S
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-1103
Mailing Address - Country:US
Mailing Address - Phone:207-862-4560
Mailing Address - Fax:
Practice Address - Street 1:415 WATER ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-2116
Practice Address - Country:US
Practice Address - Phone:207-667-5357
Practice Address - Fax:207-667-0174
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER038862163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health