Provider Demographics
NPI:1891232815
Name:JONES, JANEL M (PA-C)
Entity Type:Individual
Prefix:
First Name:JANEL
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JANEL
Other - Middle Name:M
Other - Last Name:KEIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 W MCCREIGHT AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1890
Mailing Address - Country:US
Mailing Address - Phone:937-717-4884
Mailing Address - Fax:937-717-6207
Practice Address - Street 1:100 W MCCREIGHT AVE STE 110
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1890
Practice Address - Country:US
Practice Address - Phone:937-717-4884
Practice Address - Fax:937-717-6207
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-28
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004962RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant