Provider Demographics
NPI:1487269437
Name:JONES, CATHY (LPN)
Entity type:Individual
Prefix:
First Name:CATHY
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 1:2047 DUTCH VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-5121
Mailing Address - Country:US
Mailing Address - Phone:865-607-0067
Mailing Address - Fax:
Practice Address - Street 1:2047 DUTCH VALLEY RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-5121
Practice Address - Country:US
Practice Address - Phone:865-607-0067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN0000062724164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse