Provider Demographics
NPI:1932983293
Name:JONES, MARDEE (NP)
Entity Type:Individual
Prefix:
First Name:MARDEE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 S 500 E APT E301
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-4567
Mailing Address - Country:US
Mailing Address - Phone:801-388-1643
Mailing Address - Fax:
Practice Address - Street 1:1750 SIDEWINDER DR
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7570
Practice Address - Country:US
Practice Address - Phone:435-649-7640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program