Provider Demographics
NPI:1548770290
Name:JONES, JENNAY NEELEY (NP-C)
Entity type:Individual
Prefix:
First Name:JENNAY
Middle Name:NEELEY
Last Name:JONES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JENNAY
Other - Middle Name:NEELEY
Other - Last Name:LESLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:285 W 12TH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IN
Mailing Address - Zip Code:46970-1654
Mailing Address - Country:US
Mailing Address - Phone:765-475-8500
Mailing Address - Fax:260-479-2922
Practice Address - Street 1:285 W 12TH ST STE 106
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-1654
Practice Address - Country:US
Practice Address - Phone:765-475-8500
Practice Address - Fax:260-479-2922
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007680A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily