Provider Demographics
NPI:1790291102
Name:JONES, OLIVIA L
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6844 SADDLEBROOK LOOP
Mailing Address - Street 2:
Mailing Address - City:EVERTON
Mailing Address - State:AR
Mailing Address - Zip Code:72633-8232
Mailing Address - Country:US
Mailing Address - Phone:870-754-1238
Mailing Address - Fax:
Practice Address - Street 1:6844 SADDLEBROOK LOOP
Practice Address - Street 2:
Practice Address - City:EVERTON
Practice Address - State:AR
Practice Address - Zip Code:72633-8232
Practice Address - Country:US
Practice Address - Phone:870-754-1238
Practice Address - Fax:870-754-1238
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN