Provider Demographics
NPI:1992065114
Name:JONES, PAMELA ELIZABETH (LPN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ELIZABETH
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 1:19 11TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-1449
Mailing Address - Country:US
Mailing Address - Phone:518-272-6097
Mailing Address - Fax:
Practice Address - Street 1:156 8TH AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-1043
Practice Address - Country:US
Practice Address - Phone:518-720-4619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY310039164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse