Provider Demographics
NPI:1801019278
Name:JONES, ESTRELLA RAY
Entity Type:Individual
Prefix:MRS
First Name:ESTRELLA
Middle Name:RAY
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 1:9479 PARKMAN ROAD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:OH
Mailing Address - Zip Code:44288
Mailing Address - Country:US
Mailing Address - Phone:330-348-7673
Mailing Address - Fax:330-326-3883
Practice Address - Street 1:9479 PARKMAN ROAD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:OH
Practice Address - Zip Code:44288
Practice Address - Country:US
Practice Address - Phone:330-348-7673
Practice Address - Fax:330-326-3883
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2279565374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH67508472903Medicaid