Provider Demographics
NPI:1952035214
Name:JONES, COLLEEN ELISE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:ELISE
Last Name:JONES
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:ELISE
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1167
Practice Address - Country:US
Practice Address - Phone:717-242-7270
Practice Address - Fax:717-242-7255
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
PADN007916133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered