Provider Demographics
NPI:1548972813
Name:LONON, ARIS JADE
Entity type:Individual
Prefix:
First Name:ARIS
Middle Name:JADE
Last Name:LONON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 BULL BAY DR
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-7274
Mailing Address - Country:US
Mailing Address - Phone:912-246-9660
Mailing Address - Fax:
Practice Address - Street 1:430 LEDFORD ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:GA
Practice Address - Zip Code:31321-3132
Practice Address - Country:US
Practice Address - Phone:912-653-4331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN285615163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health