Provider Demographics
NPI:1659585933
Name:JONES, STEPHANIE A (PCA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-2244
Mailing Address - Country:US
Mailing Address - Phone:740-623-2184
Mailing Address - Fax:
Practice Address - Street 1:232 S 7TH ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-2101
Practice Address - Country:US
Practice Address - Phone:740-294-3477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2661614Medicaid