Provider Demographics
NPI:1689943599
Name:JONES, AMANDA KAE
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KAE
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 1:346 HOMEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3840
Mailing Address - Country:US
Mailing Address - Phone:304-494-5184
Mailing Address - Fax:
Practice Address - Street 1:346 HOMEWOOD RD
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3840
Practice Address - Country:US
Practice Address - Phone:304-494-5184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist