Provider Demographics
NPI:1376906552
Name:JONES, KRISTEN (DO)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E INDUSTRIAL DR UNIT 627
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-0820
Mailing Address - Country:US
Mailing Address - Phone:414-850-7586
Mailing Address - Fax:
Practice Address - Street 1:401 E INDUSTRIAL DR UNIT 627
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-0820
Practice Address - Country:US
Practice Address - Phone:414-850-7586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI81575-21207R00000X, 207RC0200X
MO2021023177207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine