Provider Demographics
NPI:1003176256
Name:JONES-DRAGON, RAE ANN MICHELLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RAE ANN
Middle Name:MICHELLE
Last Name:JONES-DRAGON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-3740
Mailing Address - Country:US
Mailing Address - Phone:440-813-2330
Mailing Address - Fax:
Practice Address - Street 1:128 MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-3740
Practice Address - Country:US
Practice Address - Phone:440-813-2330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.137203-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse