Provider Demographics
NPI:1932528171
Name:JONES, CARRIE A (MASTER OF SPECIAL ED)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:MASTER OF SPECIAL ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 CALLE DE ALEGRA STE A
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3423
Mailing Address - Country:US
Mailing Address - Phone:575-526-1105
Mailing Address - Fax:575-524-4266
Practice Address - Street 1:2211 N. VALLEY
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007
Practice Address - Country:US
Practice Address - Phone:575-571-4893
Practice Address - Fax:575-527-4287
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM72545Medicaid