Provider Demographics
NPI:1134903693
Name:JONES, CARON LORAINE
Entity type:Individual
Prefix:
First Name:CARON
Middle Name:LORAINE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 BLAINE HWY
Mailing Address - Street 2:
Mailing Address - City:ELK GARDEN
Mailing Address - State:WV
Mailing Address - Zip Code:26717-9629
Mailing Address - Country:US
Mailing Address - Phone:304-788-5467
Mailing Address - Fax:304-788-6363
Practice Address - Street 1:93 BLAINE HWY
Practice Address - Street 2:
Practice Address - City:ELK GARDEN
Practice Address - State:WV
Practice Address - Zip Code:26717-9629
Practice Address - Country:US
Practice Address - Phone:304-788-5467
Practice Address - Fax:304-788-6363
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant