Provider Demographics
NPI:1124476650
Name:JONES, KATIE MARIE (QBHP)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:QBHP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:MARIE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:QBHP
Mailing Address - Street 1:1316 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LEAD HILL
Mailing Address - State:AR
Mailing Address - Zip Code:72644-9476
Mailing Address - Country:US
Mailing Address - Phone:870-754-1307
Mailing Address - Fax:
Practice Address - Street 1:1316 W 1ST ST
Practice Address - Street 2:
Practice Address - City:LEAD HILL
Practice Address - State:AR
Practice Address - Zip Code:72644-9476
Practice Address - Country:US
Practice Address - Phone:870-754-1307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator