Provider Demographics
NPI:1912047069
Name:JONES, JEANNINE G (MN, APRN)
Entity Type:Individual
Prefix:
First Name:JEANNINE
Middle Name:G
Last Name:JONES
Suffix:
Gender:F
Credentials:MN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 N MEDICAL DR
Mailing Address - Street 2:NBICU 2ND FLOOR
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0001
Mailing Address - Country:US
Mailing Address - Phone:801-585-7970
Mailing Address - Fax:801-581-5060
Practice Address - Street 1:50 N MEDICAL DR
Practice Address - Street 2:NBICU 2ND FLOOR ROOM 2705
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-585-7970
Practice Address - Fax:801-581-5060
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT221008-4405363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care