Provider Demographics
NPI:1588060156
Name:JONES, JAMIE (LM, CPM)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3302 N 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3012
Mailing Address - Country:US
Mailing Address - Phone:602-315-4616
Mailing Address - Fax:602-296-0346
Practice Address - Street 1:727 E PORTLAND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-3177
Practice Address - Country:US
Practice Address - Phone:602-315-4616
Practice Address - Fax:602-296-0346
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ191176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife