Provider Demographics
NPI:1710480405
Name:JONES, MANDI ELIZABETH (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MANDI
Middle Name:ELIZABETH
Last Name:JONES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:MANDI
Other - Middle Name:ELIZABETH
Other - Last Name:HIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1914 MERCER AVE
Mailing Address - Street 2:
Mailing Address - City:FARRELL
Mailing Address - State:PA
Mailing Address - Zip Code:16121-2505
Mailing Address - Country:US
Mailing Address - Phone:724-981-9815
Mailing Address - Fax:724-981-2293
Practice Address - Street 1:1914 MERCER AVE
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-2505
Practice Address - Country:US
Practice Address - Phone:724-981-9815
Practice Address - Fax:724-981-2293
Is Sole Proprietor?:No
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN273150164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse