Provider Demographics
NPI:1790001188
Name:JONES, KATHERINE ELIZABETH (LPN)
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:JONES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 E PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:VILLAS
Mailing Address - State:NJ
Mailing Address - Zip Code:08251-2637
Mailing Address - Country:US
Mailing Address - Phone:609-968-2520
Mailing Address - Fax:
Practice Address - Street 1:307 E PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:VILLAS
Practice Address - State:NJ
Practice Address - Zip Code:08251-2637
Practice Address - Country:US
Practice Address - Phone:609-968-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-11
Last Update Date:2010-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP06262400164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse