Provider Demographics
NPI:1154103836
Name:JONES, KAYLEY RENEE (LPN)
Entity type:Individual
Prefix:
First Name:KAYLEY
Middle Name:RENEE
Last Name:JONES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 COUNTRY CLUB LN
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2319
Mailing Address - Country:US
Mailing Address - Phone:276-237-4694
Mailing Address - Fax:
Practice Address - Street 1:140 LARKSPUR LN
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2752
Practice Address - Country:US
Practice Address - Phone:276-920-4199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002101339164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse