Provider Demographics
NPI:1184904237
Name:JONES, DEBORAH K (PNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:K
Last Name:JONES
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-1625
Mailing Address - Country:US
Mailing Address - Phone:865-368-1074
Mailing Address - Fax:
Practice Address - Street 1:194 MISSILE AVE
Practice Address - Street 2:
Practice Address - City:MINOT AFB
Practice Address - State:ND
Practice Address - Zip Code:58704
Practice Address - Country:US
Practice Address - Phone:701-723-5370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN96820163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics