Provider Demographics
NPI:1528375987
Name:JONES, TAMI DENISE (LPN)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:DENISE
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 1:1800 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-2204
Mailing Address - Country:US
Mailing Address - Phone:216-235-1996
Mailing Address - Fax:
Practice Address - Street 1:1800 BUENA VISTA DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-2204
Practice Address - Country:US
Practice Address - Phone:216-235-1996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.099807-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse