Provider Demographics
NPI:1134398779
Name:JONES, SANDRA KAY (LPN)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:KAY
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 1:19541 W MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:OH
Mailing Address - Zip Code:44609-9245
Mailing Address - Country:US
Mailing Address - Phone:330-584-1958
Mailing Address - Fax:
Practice Address - Street 1:19541 W MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:OH
Practice Address - Zip Code:44609-9245
Practice Address - Country:US
Practice Address - Phone:330-584-1958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN093319164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse