Provider Demographics
NPI:1417490053
Name:JONES, LORIANN (CNM, LM)
Entity Type:Individual
Prefix:
First Name:LORIANN
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CNM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:BUHL
Mailing Address - State:ID
Mailing Address - Zip Code:83316-5039
Mailing Address - Country:US
Mailing Address - Phone:208-543-9194
Mailing Address - Fax:
Practice Address - Street 1:702 HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:BUHL
Practice Address - State:ID
Practice Address - Zip Code:83316-5039
Practice Address - Country:US
Practice Address - Phone:208-543-9194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMID-73176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife