Provider Demographics
NPI:1851477855
Name:JONES, SHIRON DEVERE (NP)
Entity Type:Individual
Prefix:
First Name:SHIRON
Middle Name:DEVERE
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 HUNTINGTON PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5618
Mailing Address - Country:US
Mailing Address - Phone:614-340-6717
Mailing Address - Fax:
Practice Address - Street 1:1222 S PATTERSON BLVD STE 230
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2643
Practice Address - Country:US
Practice Address - Phone:937-853-3650
Practice Address - Fax:937-853-4367
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-250680363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHQ72670Medicare UPIN
OHJONP22071Medicare PIN