Provider Demographics
NPI:1467095448
Name:JONES, KENDILL MAY
Entity Type:Individual
Prefix:MISS
First Name:KENDILL
Middle Name:MAY
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 1:991 HWY 574
Mailing Address - Street 2:
Mailing Address - City:AZTEC
Mailing Address - State:NM
Mailing Address - Zip Code:87410
Mailing Address - Country:US
Mailing Address - Phone:505-444-0183
Mailing Address - Fax:
Practice Address - Street 1:403 ANDREW D
Practice Address - Street 2:
Practice Address - City:AZTEC
Practice Address - State:NM
Practice Address - Zip Code:87410
Practice Address - Country:US
Practice Address - Phone:505-333-7514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider