Provider Demographics
NPI:1184626566
Name:JONES, ALLEN M (CRNP)
Entity type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 HOLLYWOOD DR FL 2
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-5600
Mailing Address - Country:US
Mailing Address - Phone:724-282-6175
Mailing Address - Fax:724-482-1115
Practice Address - Street 1:160 HOLLYWOOD DR FL 2
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5600
Practice Address - Country:US
Practice Address - Phone:724-282-6175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP000705C363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA704112SDBMedicare PIN
PAS34504Medicare UPIN