Provider Demographics
NPI:1285218578
Name:JONES, LAURA A (IBCLC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3234 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-6116
Mailing Address - Country:US
Mailing Address - Phone:931-707-8700
Mailing Address - Fax:931-456-0802
Practice Address - Street 1:3234 MILLER AVE
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-6116
Practice Address - Country:US
Practice Address - Phone:931-707-8700
Practice Address - Fax:931-456-0802
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X
TN42377164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No164W00000XNursing Service ProvidersLicensed Practical Nurse