Provider Demographics
NPI:1083600993
Name:JONES, FRANK JEFFREY (CRNA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JEFFREY
Last Name:JONES
Suffix:
Gender:M
Credentials:CRNA
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 50850
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-4150
Mailing Address - Country:US
Mailing Address - Phone:800-919-1190
Mailing Address - Fax:
Practice Address - Street 1:1625 NASHVILLE ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:KY
Practice Address - Zip Code:42276-8853
Practice Address - Country:US
Practice Address - Phone:270-726-4011
Practice Address - Fax:270-726-2008
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2476A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY74462318Medicaid
KY0691301Medicare PIN
S45607Medicare UPIN