Provider Demographics
NPI:1598930083
Name:JONES, ANGENELLA (RT)
Entity Type:Individual
Prefix:
First Name:ANGENELLA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 N OUTER DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-6151
Mailing Address - Country:US
Mailing Address - Phone:989-697-6375
Mailing Address - Fax:
Practice Address - Street 1:1422 NORTH 0UTER DRIVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601
Practice Address - Country:US
Practice Address - Phone:989-607-6375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL10037542278E0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278E0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedEmergency Care