Provider Demographics
NPI:1104567890
Name:JONES, KRISTA NICOLE (ND)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:NICOLE
Last Name:JONES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13402 N SCOTTSDALE RD STE A120
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4036
Mailing Address - Country:US
Mailing Address - Phone:480-360-0115
Mailing Address - Fax:
Practice Address - Street 1:13402 N SCOTTSDALE RD STE A120
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4036
Practice Address - Country:US
Practice Address - Phone:480-360-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22-1712175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath