Provider Demographics
NPI:1194033647
Name:JONES, PAULA C (DPH)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:C
Last Name:JONES
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9810 HIGHWAY 57
Mailing Address - Street 2:
Mailing Address - City:COUNCE
Mailing Address - State:TN
Mailing Address - Zip Code:38326-3725
Mailing Address - Country:US
Mailing Address - Phone:731-689-5222
Mailing Address - Fax:731-689-5425
Practice Address - Street 1:9810 HIGHWAY 57
Practice Address - Street 2:
Practice Address - City:COUNCE
Practice Address - State:TN
Practice Address - Zip Code:38326-3725
Practice Address - Country:US
Practice Address - Phone:731-689-5222
Practice Address - Fax:731-689-5425
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1492183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist