Provider Demographics
NPI:1447467618
Name:JONES, RODERICK LARAMEE (NURSE)
Entity type:Individual
Prefix:MR
First Name:RODERICK
Middle Name:LARAMEE
Last Name:JONES
Suffix:
Gender:M
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7512 ROCKRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5734
Mailing Address - Country:US
Mailing Address - Phone:410-653-0034
Mailing Address - Fax:410-653-3929
Practice Address - Street 1:3300 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-3383
Practice Address - Country:US
Practice Address - Phone:410-750-3474
Practice Address - Fax:410-750-3478
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR084650163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse