Provider Demographics
NPI:1215401104
Name:JONES, TANNETHIA
Entity Type:Individual
Prefix:MS
First Name:TANNETHIA
Middle Name:
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 1:3778 E 151ST ST # DN
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-1106
Mailing Address - Country:US
Mailing Address - Phone:216-288-1091
Mailing Address - Fax:
Practice Address - Street 1:3778 E 151ST ST # DN
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1106
Practice Address - Country:US
Practice Address - Phone:216-288-1091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health