Provider Demographics
NPI:1831173012
Name:JONES, LISA H (NP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:H
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 N ARLINGTON AVE
Mailing Address - Street 2:101
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-3286
Mailing Address - Country:US
Mailing Address - Phone:317-352-9171
Mailing Address - Fax:317-353-0287
Practice Address - Street 1:1311 N ARLINGTON AVE
Practice Address - Street 2:101
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3286
Practice Address - Country:US
Practice Address - Phone:317-352-9171
Practice Address - Fax:317-353-0287
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71000239A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN115340DMedicare ID - Type Unspecified