Provider Demographics
NPI:1710345350
Name:JONES, SANDY (RN)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 10TH ST N
Mailing Address - Street 2:STE 320, #3
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-6158
Mailing Address - Country:US
Mailing Address - Phone:651-283-4644
Mailing Address - Fax:
Practice Address - Street 1:6230 10TH ST N
Practice Address - Street 2:STE 320, #3
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-6158
Practice Address - Country:US
Practice Address - Phone:651-283-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR197868163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse