Provider Demographics
NPI:1720248412
Name:JONES, CAROLYN YVONNE (LPN)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:YVONNE
Last Name:JONES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:YVONNE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:3711 STINSON AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-7707
Mailing Address - Country:US
Mailing Address - Phone:225-806-5197
Mailing Address - Fax:
Practice Address - Street 1:910 N BON MARCHE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-2257
Practice Address - Country:US
Practice Address - Phone:225-923-1500
Practice Address - Fax:225-923-1550
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA860544164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse