Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN-187121 | OH |
NPI | 1003915141 |
---|---|
Provider Name | Sandra J Jones |
First Address | Zanesville, OH 43701-1880 |
Second Address | Zanesville, OH 43701-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 21/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2371213 | (05) | OH |
P72998 | (02) |