Provider Demographics
NPI:1255845194
Name:JONES, VONZETTA MARIA (LPN)
Entity Type:Individual
Prefix:
First Name:VONZETTA
Middle Name:MARIA
Last Name:JONES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:VONZETTA
Other - Middle Name:MARIA
Other - Last Name:GLOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6003 BRUYNINCKX RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2108
Mailing Address - Country:US
Mailing Address - Phone:318-314-0478
Mailing Address - Fax:318-441-2251
Practice Address - Street 1:4606 LEE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71302-3235
Practice Address - Country:US
Practice Address - Phone:318-441-1105
Practice Address - Fax:318-441-2251
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA250422164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse