Provider Demographics
NPI:1073240875
Name:JONES, LAKEVEYA SHAQUA (CRNP)
Entity Type:Individual
Prefix:
First Name:LAKEVEYA
Middle Name:SHAQUA
Last Name:JONES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 HAROLD ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-2704
Mailing Address - Country:US
Mailing Address - Phone:334-492-0470
Mailing Address - Fax:
Practice Address - Street 1:207 DR L C MCMILLIAN AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081-3605
Practice Address - Country:US
Practice Address - Phone:334-492-0470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-141464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily