Provider Demographics
NPI:1124602115
Name:JONES-HARVEY, LEKISHA ANN-MARIE
Entity Type:Individual
Prefix:MRS
First Name:LEKISHA
Middle Name:ANN-MARIE
Last Name:JONES-HARVEY
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 1:210 PINE ST APT 221
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-8410
Mailing Address - Country:US
Mailing Address - Phone:860-878-5028
Mailing Address - Fax:860-548-7328
Practice Address - Street 1:55 FISHFRY STREET
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120-1203
Practice Address - Country:US
Practice Address - Phone:860-247-8300
Practice Address - Fax:860-548-7325
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT34740164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse