Provider Demographics
NPI:1336697119
Name:JONES, PATRICIA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8272 S GREENSBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:KNIGHTSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46148
Mailing Address - Country:US
Mailing Address - Phone:765-571-1215
Mailing Address - Fax:
Practice Address - Street 1:1100 EAST 5TH STREET
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012
Practice Address - Country:US
Practice Address - Phone:765-571-1215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer