Provider Demographics
NPI:1801824149
Name:JONES, MARY ELIZABETH (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65805 SOLAR RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:OK
Mailing Address - Zip Code:81401
Mailing Address - Country:US
Mailing Address - Phone:970-249-8704
Mailing Address - Fax:
Practice Address - Street 1:65805 SOLAR RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-8534
Practice Address - Country:US
Practice Address - Phone:970-249-8704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0039152163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP37866Medicare UPIN