Provider Demographics
NPI:1184384653
Name:JONES, JEREMIAH (CNA)
Entity type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 WILKINSON CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-3751
Mailing Address - Country:US
Mailing Address - Phone:304-546-3316
Mailing Address - Fax:
Practice Address - Street 1:327 WILKINSON CT
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-3751
Practice Address - Country:US
Practice Address - Phone:304-546-3316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV59100376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide