Provider Demographics
NPI:1942536735
Name:CANNON-JONES, CHIQUITA ANNETTE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHIQUITA
Middle Name:ANNETTE
Last Name:CANNON-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 1:2328 STONEPATH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-1189
Mailing Address - Country:US
Mailing Address - Phone:216-548-9675
Mailing Address - Fax:440-245-0136
Practice Address - Street 1:2328 STONEPATH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-1189
Practice Address - Country:US
Practice Address - Phone:216-548-9675
Practice Address - Fax:440-245-0136
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 128063 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse