Healthcare Provider Details

I. General information

NPI: 1003125006
Provider Name (Legal Business Name): LAUREN LEIGH JONES CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2010
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 BANK ST APT 204
BALTIMORE MD
21202-4308
US

IV. Provider business mailing address

1220 BANK ST APT 204
BALTIMORE MD
21202-4308
US

V. Phone/Fax

Practice location:
  • Phone: 770-843-0366
  • Fax:
Mailing address:
  • Phone: 770-843-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN-CRNA176907
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number164297
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN176907
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: