Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 01086011A | IN |
N | 207V00000X | Obstetrician & Gynecologist | 125070990 | IL |
NPI | 1013447853 |
---|---|
Provider Name | Dana Dawnielle Jones |
First Address | Portage, IN 46368-7752 |
Second Address | Portage, IN 46368-7752 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2017 |
Last Update Date | 23/06/2021 |