1821122441 NPI number — MRS. GINA MARIE JONES CNP

Table of content: MRS. GINA MARIE JONES CNP (NPI 1821122441)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821122441 NPI number — MRS. GINA MARIE JONES CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
GINA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821122441
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1461 CORNERSTONE ST SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARTVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44632-8935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-715-8486
Provider Business Mailing Address Fax Number:
330-478-3341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4048 DRESSLER RD NW
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44718-2784
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-478-4132
Provider Business Practice Location Address Fax Number:
330-478-3341
Provider Enumeration Date:
03/15/2007

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: 363LA2200X , with the licence number:  0357076-21 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2907457 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 05181-RX . This is a "CERTIFICATE TO PRESCRIBE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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