Provider Demographics
NPI:1083384614
Name:KING-JONES, PATRICIA ARLENE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ARLENE
Last Name:KING-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 1:104 BREWER AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-5602
Mailing Address - Country:US
Mailing Address - Phone:757-949-7728
Mailing Address - Fax:757-210-4271
Practice Address - Street 1:104 BREWER AVE
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5602
Practice Address - Country:US
Practice Address - Phone:757-949-7728
Practice Address - Fax:757-210-4271
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide