Provider Demographics
NPI:1437421351
Name:JONES, LYNN ELLEN (LPN)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ELLEN
Last Name:JONES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:696 STATE HIGHWAY 7 LOT 35
Mailing Address - Street 2:
Mailing Address - City:UNADILLA
Mailing Address - State:NY
Mailing Address - Zip Code:13849-3112
Mailing Address - Country:US
Mailing Address - Phone:607-423-5924
Mailing Address - Fax:
Practice Address - Street 1:696 STATE HIGHWAY 7 LOT 35
Practice Address - Street 2:
Practice Address - City:UNADILLA
Practice Address - State:NY
Practice Address - Zip Code:13849-3112
Practice Address - Country:US
Practice Address - Phone:607-423-5924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275738164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse