Provider Demographics
NPI:1013565407
Name:JONES, KATHLEEN (LDN, CNS)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LDN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5265 ROCKROSE LN BLDG E15
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-8248
Mailing Address - Country:US
Mailing Address - Phone:570-972-6558
Mailing Address - Fax:
Practice Address - Street 1:3131 COLLEGE HEIGHTS BLVD STE 2400
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4817
Practice Address - Country:US
Practice Address - Phone:610-432-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
PADN006874133NN1002X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No174H00000XOther Service ProvidersHealth Educator
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education