Provider Demographics
NPI:1356414460
Name:COLES JONES, FAYE (DC)
Entity type:Individual
Prefix:DR
First Name:FAYE
Middle Name:
Last Name:COLES JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:NE
Mailing Address - Zip Code:68008-1600
Mailing Address - Country:US
Mailing Address - Phone:402-426-4443
Mailing Address - Fax:402-426-4604
Practice Address - Street 1:1526 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BLAIR
Practice Address - State:NE
Practice Address - Zip Code:68008-1600
Practice Address - Country:US
Practice Address - Phone:402-426-4443
Practice Address - Fax:402-426-4604
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47063669800Medicaid
NE47063669800Medicaid
NET40164Medicare UPIN