Provider Demographics
NPI:1578805834
Name:JONES, PAUL ROBERT (LPN)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ROBERT
Last Name:JONES
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 WILBUR AVE
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-6659
Mailing Address - Country:US
Mailing Address - Phone:330-745-6313
Mailing Address - Fax:330-745-6313
Practice Address - Street 1:1004 WILBUR AVE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-6659
Practice Address - Country:US
Practice Address - Phone:330-745-6313
Practice Address - Fax:330-745-6313
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN096534164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse