Provider Demographics
NPI:1043367808
Name:CAPUTO-JONES, TERRI M (CRNP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:M
Last Name:CAPUTO-JONES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4465
Mailing Address - Country:US
Mailing Address - Phone:937-435-1445
Mailing Address - Fax:937-439-7552
Practice Address - Street 1:330 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4465
Practice Address - Country:US
Practice Address - Phone:937-435-1445
Practice Address - Fax:937-439-7552
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.06448-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2828159Medicaid
OHH149830Medicare PIN
OHCANP26441Medicare PIN