Provider Demographics
NPI:1649700220
Name:JONES, MARY KATHLEEN (SBD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHLEEN
Last Name:JONES
Suffix:
Gender:F
Credentials:SBD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:KATHLEEN
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 E PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81503-2034
Mailing Address - Country:US
Mailing Address - Phone:478-993-7191
Mailing Address - Fax:
Practice Address - Street 1:255 E PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81503-2034
Practice Address - Country:US
Practice Address - Phone:478-993-7191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula