Healthcare Provider Details

I. General information

NPI: 1851182729
Provider Name (Legal Business Name): ELLYN ROSE JONES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST FL 1
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

2065 HEATHER WAY
LEXINGTON KY
40503-2657
US

V. Phone/Fax

Practice location:
  • Phone: 859-562-1085
  • Fax: 859-257-5152
Mailing address:
  • Phone: 859-321-6355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number4046350
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number1139925
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: