Provider Demographics
NPI:1437935426
Name:JONES, ELISHA EVALYNN
Entity Type:Individual
Prefix:
First Name:ELISHA
Middle Name:EVALYNN
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 1:13155 LIBERTY HI RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-9511
Mailing Address - Country:US
Mailing Address - Phone:419-309-0549
Mailing Address - Fax:
Practice Address - Street 1:13155 LIBERTY HI RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-9511
Practice Address - Country:US
Practice Address - Phone:419-309-0549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant