Provider Demographics
NPI:1548587165
Name:JONES, PATRICE (LPN)
Entity Type:Individual
Prefix:MS
First Name:PATRICE
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 1:5704 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-6450
Mailing Address - Country:US
Mailing Address - Phone:216-906-8227
Mailing Address - Fax:
Practice Address - Street 1:5704 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-6450
Practice Address - Country:US
Practice Address - Phone:216-906-8227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-125152164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse