Provider Demographics
NPI:1013508738
Name:JONES, PRISCILLA MICHELLE
Entity type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:MICHELLE
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 1:836 SE OLD COUNTY CAMP RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340
Mailing Address - Country:US
Mailing Address - Phone:859-673-1647
Mailing Address - Fax:
Practice Address - Street 1:836 SE OLD COUNTY CAMP RD
Practice Address - Street 2:836 SE OLD COUNTY CAMP RD
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340
Practice Address - Country:US
Practice Address - Phone:850-673-1647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide