Provider Demographics
NPI:1083253967
Name:JONES, NICKY JAYNE
Entity Type:Individual
Prefix:
First Name:NICKY
Middle Name:JAYNE
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 1:5437 SW 88TH CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4125
Mailing Address - Country:US
Mailing Address - Phone:352-215-0504
Mailing Address - Fax:
Practice Address - Street 1:5437 SW 88TH CT
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-4125
Practice Address - Country:US
Practice Address - Phone:352-215-0504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-24
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula