Provider Demographics
NPI:1730715822
Name:JONES, SUZETTE (NP)
Entity type:Individual
Prefix:MS
First Name:SUZETTE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MID-STATE OCCUPATIONAL HEALTH SERVICES, INC.
Mailing Address - Street 2:1000 MEADE STREET
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512
Mailing Address - Country:US
Mailing Address - Phone:570-209-7160
Mailing Address - Fax:570-209-7164
Practice Address - Street 1:MID-STATE OCCUPATIONAL HEALTH SERVICES, INC.
Practice Address - Street 2:1000 MEADE STREET
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512
Practice Address - Country:US
Practice Address - Phone:570-209-7160
Practice Address - Fax:570-209-7164
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021335363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health