Provider Demographics
NPI:1003681008
Name:JONES, RANESHA ANN
Entity Type:Individual
Prefix:
First Name:RANESHA
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29300 WOODWARD AVE APT 119
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-0960
Mailing Address - Country:US
Mailing Address - Phone:313-595-0312
Mailing Address - Fax:
Practice Address - Street 1:29300 WOODWARD AVE APT 119
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0960
Practice Address - Country:US
Practice Address - Phone:313-595-0312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
MI230014407521108374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide