Individual provider · NPI-1
Stacey Lynette Jones
Technician, Attendant Care Provider · Mableton, GA
NPI number1285284463
StatusActive
Last updated in NPPESSep 18, 2019
Details
- NPI
- 1285284463
- Entity type
- Individual (NPI-1)
- Name
- Stacey Lynette Jones
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 18, 2019
- Last updated
- Sep 18, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
3609 Abatis Way SeMableton, GA 30126-2891
Phone 404-909-5815
Mailing address
3609 Abatis Way SeMableton, GA 30126-2891
Phone 404-909-5815
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