Provider Demographics
NPI:1689899767
Name:JONES, DEBRA JOANN (RN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:JOANN
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 WESTGATE DRIVE
Mailing Address - Street 2:SUITE 190
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114
Mailing Address - Country:US
Mailing Address - Phone:651-312-1500
Mailing Address - Fax:651-312-1593
Practice Address - Street 1:606 24TH AVE S
Practice Address - Street 2:SUITE 515
Practice Address - City:MPLS
Practice Address - State:MN
Practice Address - Zip Code:55454
Practice Address - Country:US
Practice Address - Phone:651-225-7830
Practice Address - Fax:651-225-7989
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR1247888163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse