Provider Demographics
NPI:1003488164
Name:JONES, LASONYA (FNP)
Entity Type:Individual
Prefix:
First Name:LASONYA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5412 SUSANNA DR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-4944
Mailing Address - Country:US
Mailing Address - Phone:318-401-1432
Mailing Address - Fax:318-562-3889
Practice Address - Street 1:7840 JEWELLA AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71108-5004
Practice Address - Country:US
Practice Address - Phone:318-401-1432
Practice Address - Fax:318-562-3889
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA221039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily