1154961571 NPI number — CORINA L JONES M.S. CERTI IN ELDER

Table of content: CORINA L JONES M.S. CERTI IN ELDER (NPI 1154961571)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154961571 NPI number — CORINA L JONES M.S. CERTI IN ELDER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
CORINA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S. CERTI IN ELDER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JONES
Provider Other First Name:
CORINA
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.S., M. CERTIF GERI
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1154961571
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1210 TERRA HILL DR APT 4B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19809-3535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-457-5258
Provider Business Mailing Address Fax Number:
302-689-6564

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1210 TERRA HILL DR APT 4B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19809-3535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-457-5258
Provider Business Practice Location Address Fax Number:
302-689-6564
Provider Enumeration Date:
01/14/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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