Provider Demographics
NPI:1619423183
Name:JONES, TAYLIA
Entity Type:Individual
Prefix:
First Name:TAYLIA
Middle Name:
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 1:11908 SILVER CREEK DR
Mailing Address - Street 2:APT #1
Mailing Address - City:BIRCH RUN
Mailing Address - State:MI
Mailing Address - Zip Code:48415-9746
Mailing Address - Country:US
Mailing Address - Phone:810-391-6289
Mailing Address - Fax:
Practice Address - Street 1:11908 SILVER CREEK DR
Practice Address - Street 2:APT #1
Practice Address - City:BIRCH RUN
Practice Address - State:MI
Practice Address - Zip Code:48415-9746
Practice Address - Country:US
Practice Address - Phone:810-391-6289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other