Provider Demographics
NPI:1134534753
Name:JONES, JUDY (L V N)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:L V N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 SOUTH FWY
Mailing Address - Street 2:SUITE 800
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-1400
Mailing Address - Country:US
Mailing Address - Phone:817-920-5752
Mailing Address - Fax:817-920-5772
Practice Address - Street 1:4200 SOUTH FWY
Practice Address - Street 2:SUITE 800
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-1400
Practice Address - Country:US
Practice Address - Phone:817-920-5752
Practice Address - Fax:817-920-5772
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74284164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse