Provider Demographics
NPI:1235735028
Name:JONES, DYWANA M
Entity Type:Individual
Prefix:
First Name:DYWANA
Middle Name:M
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 1:4710 MEISTER RD APT A
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1533
Mailing Address - Country:US
Mailing Address - Phone:440-538-8625
Mailing Address - Fax:
Practice Address - Street 1:4710 MEISTER RD APT A
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1533
Practice Address - Country:US
Practice Address - Phone:440-538-8625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide