=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144481730
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUSAN JAYE JONES RN NNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2008
-----------------------------------------------------
Last Update Date | 06/17/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 HEALTH PARK DR
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80027-9583
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-673-1102
-----------------------------------------------------
Fax | 303-673-1077
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4811 W 102ND PL
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80031-2323
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-404-2998
-----------------------------------------------------
Fax | 303-404-2998
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 46864
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------