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Individual

MAUDELLA GRACE JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, PMHNP

Contact information

Practice address
154 N LAKE DR, PRESTONSBURG, KY 41653-1270
(606) 263-4283
Mailing address
156 N LAKE DR, PRESTONSBURG, KY 41653-1270
(606) 263-4283
(606) 506-5039

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007270
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3007270
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
710022650
KY
01
K073146
MEDICARE
KY
Enumeration date
04/05/2012
Last updated
09/19/2023
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