Provider Demographics
NPI:1932483724
Name:JONES, CHERRELLE NICHOLE (LPN)
Entity Type:Individual
Prefix:MS
First Name:CHERRELLE
Middle Name:NICHOLE
Last Name:JONES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 DEARBORN AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-2002
Mailing Address - Country:US
Mailing Address - Phone:937-219-5737
Mailing Address - Fax:
Practice Address - Street 1:440 DEARBORN AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-2002
Practice Address - Country:US
Practice Address - Phone:937-219-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401256880611376K00000X
OH165796164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No376K00000XNursing Service Related ProvidersNurse's Aide