Provider Demographics
NPI:1396308201
Name:JONES, KATHY LYNN
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:LYNN
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 1:4340 N HIAWASSEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-1702
Mailing Address - Country:US
Mailing Address - Phone:407-297-6995
Mailing Address - Fax:407-297-7887
Practice Address - Street 1:4340 N HIAWASSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-1702
Practice Address - Country:US
Practice Address - Phone:407-297-6995
Practice Address - Fax:407-297-7887
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator