Provider Demographics
NPI:1548770290
Name:JONES, JENNAY NEELEY (NP-C)
Entity Type:Individual
Prefix:
First Name:JENNAY
Middle Name:NEELEY
Last Name:JONES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JENNAY
Other - Middle Name:NEELEY
Other - Last Name:LESLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9306 N OLD ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:MACY
Mailing Address - State:IN
Mailing Address - Zip Code:46951-7974
Mailing Address - Country:US
Mailing Address - Phone:765-319-9700
Mailing Address - Fax:
Practice Address - Street 1:285 W 12TH ST STE 103
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-1654
Practice Address - Country:US
Practice Address - Phone:765-475-2316
Practice Address - Fax:765-475-2359
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28161077A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner