Provider Demographics
NPI:1588076038
Name:JONES, VICTORIA A
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:A
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 1:722 WALNUT ST
Mailing Address - Street 2:APT 804
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-1654
Mailing Address - Country:US
Mailing Address - Phone:573-228-8008
Mailing Address - Fax:
Practice Address - Street 1:12100 W 109TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1200
Practice Address - Country:US
Practice Address - Phone:573-228-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00000000000000000390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program