Provider Demographics
NPI:1003276650
Name:JONES, JEREMIAH (RN, NRP)
Entity Type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:RN, NRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 523
Mailing Address - Street 2:
Mailing Address - City:DEMOPOLIS
Mailing Address - State:AL
Mailing Address - Zip Code:36732-0523
Mailing Address - Country:US
Mailing Address - Phone:256-744-5394
Mailing Address - Fax:
Practice Address - Street 1:3140B JONES RD
Practice Address - Street 2:
Practice Address - City:CODEN
Practice Address - State:AL
Practice Address - Zip Code:36523-3488
Practice Address - Country:US
Practice Address - Phone:256-744-5394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0600909146L00000X
AL1-150737163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic