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General NPI Number Information
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NPI Number | 1134890460
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Entity Type | Individual
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Provider Name | MARY K JONES REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 7770 COLUMBUS RD NE
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City | LOUISVILLE
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State | OH
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Zip | 44641-9773
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Country | US
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Telephone | 330-875-1456
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Fax | 330-875-1576
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Provider Business Mailing Address
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Address Line | 7770 COLUMBUS RD NE
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City | LOUISVILLE
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State | OH
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Zip | 44641-9773
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Country | US
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Telephone | 330-875-1456
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Fax | 330-875-1576
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.289730
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License Number State | OH
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