Provider Demographics
NPI:1528141975
Name:JONES, KERRI LYNNE (NMD)
Entity type:Individual
Prefix:DR
First Name:KERRI
Middle Name:LYNNE
Last Name:JONES
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:DR
Other - First Name:KERRI
Other - Middle Name:LYNNE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NMD
Mailing Address - Street 1:34719 N 23RD DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-5569
Mailing Address - Country:US
Mailing Address - Phone:916-903-9189
Mailing Address - Fax:
Practice Address - Street 1:34719 N 23RD DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-5569
Practice Address - Country:US
Practice Address - Phone:916-903-9189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ02-694175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath