Provider Demographics
NPI:1790528289
Name:JONES, ELIZABETH ERIN (RN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ERIN
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1554 PROSPECT LAKES DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-4905
Mailing Address - Country:US
Mailing Address - Phone:636-614-8121
Mailing Address - Fax:
Practice Address - Street 1:774 GRAVOIS BLUFFS BLVD STE A
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-7758
Practice Address - Country:US
Practice Address - Phone:636-343-5223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004005156163W00000X
MO2024027175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse