Provider Demographics
NPI:1912303850
Name:JONES, LYNN LEE JR
Entity type:Individual
Prefix:MR
First Name:LYNN
Middle Name:LEE
Last Name:JONES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 SW MCGUIRE TER
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32024-1954
Mailing Address - Country:US
Mailing Address - Phone:386-438-0680
Mailing Address - Fax:
Practice Address - Street 1:468 SW MCGUIRE TER
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32024-1954
Practice Address - Country:US
Practice Address - Phone:386-438-0680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL305804376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide