Provider Demographics
NPI:1962593228
Name:JONES-SHOOK, DEBORAH H (CRNP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:H
Last Name:JONES-SHOOK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:H
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 418953
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8953
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 SCHILLING RD
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-1191
Practice Address - Country:US
Practice Address - Phone:410-771-9220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR118745363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD965803300Medicaid
MDKJ15GB/820603-02OtherCAREFIRST MARYLAND
MDS138/0035OtherCAREFIRST REGIONAL
MDCDS9/820603-02OtherCAREFIRST MD
MDS123-0108OtherCAREFIRST REGIONAL
MD965803300Medicaid
MD712L/188413YBPGMedicare PIN
MDCDS9/820603-02OtherCAREFIRST MD