Provider Demographics
NPI:1326912429
Name:JONES, JACQUELINE ROSE
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ROSE
Last Name:JONES
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:ROSE
Other - Last Name:ENSIGN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10237 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46280-1619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10237 N PARK AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46280-1619
Practice Address - Country:US
Practice Address - Phone:317-908-4881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28209597A390200000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program