Provider Demographics
NPI:1912615741
Name:JONES, CARMEN
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5244 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-1933
Mailing Address - Country:US
Mailing Address - Phone:330-503-4715
Mailing Address - Fax:
Practice Address - Street 1:5244 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-1933
Practice Address - Country:US
Practice Address - Phone:330-503-4715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide