Provider Demographics
NPI:1235877069
Name:JONES, TERAH MONAE (RN,BS)
Entity Type:Individual
Prefix:
First Name:TERAH
Middle Name:MONAE
Last Name:JONES
Suffix:
Gender:F
Credentials:RN,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 6TH AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:NY
Mailing Address - Zip Code:12189-2015
Mailing Address - Country:US
Mailing Address - Phone:518-210-1551
Mailing Address - Fax:
Practice Address - Street 1:87 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-1551
Practice Address - Country:US
Practice Address - Phone:518-449-1142
Practice Address - Fax:518-449-1320
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY751529-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse