Provider Demographics
NPI:1285461913
Name:JONES, MARILYN (CHA I)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CHA I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:KOTZEBUE
Mailing Address - State:AK
Mailing Address - Zip Code:99752-0043
Mailing Address - Country:US
Mailing Address - Phone:907-442-7161
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 49
Practice Address - Street 2:
Practice Address - City:POINT HOPE
Practice Address - State:AK
Practice Address - Zip Code:99766-0049
Practice Address - Country:US
Practice Address - Phone:907-368-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK24-1753-I172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker