Provider Demographics
NPI:1699125864
Name:JONES, YVONNE (LPN)
Entity type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:
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 1:2782 S BROADWAY
Mailing Address - Street 2:LOT 114
Mailing Address - City:WELLSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14894-9751
Mailing Address - Country:US
Mailing Address - Phone:607-767-5416
Mailing Address - Fax:
Practice Address - Street 1:2782 S BROADWAY
Practice Address - Street 2:LOT 114
Practice Address - City:WELLSBURG
Practice Address - State:NY
Practice Address - Zip Code:14894-9751
Practice Address - Country:US
Practice Address - Phone:607-767-5416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309035-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse