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Individual

DEAN EDWARD JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
514 W 2ND ST, BLOOMINGTON, IN 47403-2316
(812) 353-3716
(812) 353-9630
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003585A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201062950
IN
Enumeration date
12/20/2010
Last updated
06/19/2020
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