Provider Demographics
NPI:1861155459
Name:JONES, TERESA L
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 N 80TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-3800
Mailing Address - Country:US
Mailing Address - Phone:414-306-3033
Mailing Address - Fax:414-290-9656
Practice Address - Street 1:3310 N 80TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-3800
Practice Address - Country:US
Practice Address - Phone:414-306-3033
Practice Address - Fax:414-290-9656
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)