Provider Demographics
NPI:1881196053
Name:JONES, BETSY LORRAINE (LVN)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:LORRAINE
Last Name:JONES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-3026
Mailing Address - Country:US
Mailing Address - Phone:903-305-0924
Mailing Address - Fax:
Practice Address - Street 1:120 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:TX
Practice Address - Zip Code:75657-1934
Practice Address - Country:US
Practice Address - Phone:903-665-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108861164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse