1891135455 NPI number — MS. LASHAUNDRA KENDRIA JONES CNA

Table of content: MS. LASHAUNDRA KENDRIA JONES CNA (NPI 1891135455)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891135455 NPI number — MS. LASHAUNDRA KENDRIA JONES CNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
LASHAUNDRA
Provider Middle Name:
KENDRIA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891135455
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6008 BUCK LAKE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TALLAHASSEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32317-9514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-508-7288
Provider Business Mailing Address Fax Number:
850-224-1139

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
438 W BREVARD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TALLAHASSEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32301-1004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-224-2469
Provider Business Practice Location Address Fax Number:
850-224-1139
Provider Enumeration Date:
06/27/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 376K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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