Provider Demographics
NPI:1497757330
Name:JONES, CAROL (CFA/CST)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CFA/CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PROFESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-8005
Mailing Address - Country:US
Mailing Address - Phone:812-473-2642
Mailing Address - Fax:812-474-4458
Practice Address - Street 1:1400 PROFESSIONAL BLVD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-8005
Practice Address - Country:US
Practice Address - Phone:812-473-2642
Practice Address - Fax:812-474-4458
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
00F679OtherNATIONAL CERTIFICATION