Provider Demographics
NPI:1841011624
Name:JONES, DEBRA ANN (CHW)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12211 FELCH ST UNIT 406
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-9667
Mailing Address - Country:US
Mailing Address - Phone:616-843-7545
Mailing Address - Fax:
Practice Address - Street 1:12211 FELCH ST UNIT 406
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-9667
Practice Address - Country:US
Practice Address - Phone:616-843-7545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI180172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker