Provider Demographics
NPI:1467661520
Name:JONES, VALERIE (LPN)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
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 1:236 CHIEFS COVE RD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:45612-9700
Mailing Address - Country:US
Mailing Address - Phone:740-941-0003
Mailing Address - Fax:
Practice Address - Street 1:246 PINEHURST BLVD
Practice Address - Street 2:APT 101
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-9676
Practice Address - Country:US
Practice Address - Phone:740-941-0564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 116672 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2618868Medicaid