Provider Demographics
NPI:1043540636
Name:JONES, STEPHANIE ELIZABETH (CRNA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ELIZABETH
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ELIZABETH
Other - Last Name:STONER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:332 W BROADWAY
Mailing Address - Street 2:SUITE 810
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2130
Mailing Address - Country:US
Mailing Address - Phone:502-583-0909
Mailing Address - Fax:502-583-0913
Practice Address - Street 1:332 W BROADWAY
Practice Address - Street 2:SUITE 810
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-2130
Practice Address - Country:US
Practice Address - Phone:502-583-0909
Practice Address - Fax:502-583-0913
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1096873367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1096873OtherKY RN
KY6363AOtherCRNA
KY6363AOtherCRNA
KY0516881Medicare PIN