MEDICARE: ALECIA JONES LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	LPN.162299.MEDS-IV	OH
2	251J00000X	Nursing Care Agency	LPN.162299.MEDS-IV	OH
3	261QM0850X	Adult Mental Health Clinic/Center	LPN.162299.MEDS-IV	OH
4	302R00000X	Health Maintenance Organization	LPN.162299.MEDS-IV	OH

General Provider Information

NPI Number	:	1033641634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALECIA JONES LPN

Provider Business Mailing Address
First Line	:	1675 GLENMONT RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1160
Country	:	US
Telephone Number	:	216-857-8985
Fax Number	:

Provider Business Practice Location Address
First Line	:	1675 GLENMONT RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1160
Country	:	US
Telephone Number	:	216-857-8985
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2017
Last Update Date	:	04/01/2017

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