Provider Demographics
NPI:1043993157
Name:JONES, ANTOINETTE RYSHAWN
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:RYSHAWN
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 1:4443 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-2042
Mailing Address - Country:US
Mailing Address - Phone:567-343-9680
Mailing Address - Fax:
Practice Address - Street 1:4443 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-2042
Practice Address - Country:US
Practice Address - Phone:567-343-9680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker