Provider Demographics
NPI:1417995242
Name:JONES, ELIZABETH A (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3741 ROME DR
Mailing Address - Street 2:STE. B
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-4490
Mailing Address - Country:US
Mailing Address - Phone:765-607-6160
Mailing Address - Fax:765-607-6161
Practice Address - Street 1:3741 ROME DR
Practice Address - Street 2:STE. B
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4490
Practice Address - Country:US
Practice Address - Phone:765-607-6160
Practice Address - Fax:765-607-6161
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71001247A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200491790Medicaid