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General NPI Number Information
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NPI Number | 1144734070
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Entity Type | Organization
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Legal Business Name | LJ HEALTH CARE SERVICES
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Dates
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Enumeration Date | 11/30/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1762 HUMMINGBIRD CT
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City | MARCO ISLAND
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State | FL
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Zip | 34145-4108
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Country | US
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Telephone | 614-738-2161
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Fax |
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Provider Business Mailing Address
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Address Line | 1762 HUMMINGBIRD CT
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City | MARCO ISLAND
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State | FL
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Zip | 34145-4108
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Country | US
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Telephone | 614-738-2161
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAURA L JONES
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Credential | NURSE PRACTITIONER
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Telephone | 614-738-2161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9454866
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License Number State | FL
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