Provider Demographics
NPI:1033641634
Name:JONES, ALECIA (LPN)
Entity Type:Individual
Prefix:
First Name:ALECIA
Middle Name:
Last Name:JONES
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 1:1675 GLENMONT RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1160
Mailing Address - Country:US
Mailing Address - Phone:216-857-8985
Mailing Address - Fax:
Practice Address - Street 1:1675 GLENMONT RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1160
Practice Address - Country:US
Practice Address - Phone:216-857-8985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-01
Last Update Date:2017-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.162299.MEDS-IV164W00000X, 251J00000X, 261QM0850X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No251J00000XAgenciesNursing Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization