Provider Demographics
NPI:1093024986
Name:JONES, MARTHA CHIMEZIE (RN)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:CHIMEZIE
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 OSCEOLA ST
Mailing Address - Street 2:
Mailing Address - City:MATTAPAN
Mailing Address - State:MA
Mailing Address - Zip Code:02126-1974
Mailing Address - Country:US
Mailing Address - Phone:857-342-7441
Mailing Address - Fax:
Practice Address - Street 1:54 OSCEOLA ST
Practice Address - Street 2:
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-1974
Practice Address - Country:US
Practice Address - Phone:857-342-7441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN272110163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse