Provider Demographics
NPI:1275388571
Name:JONES, TAMELA LASHAUN
Entity Type:Individual
Prefix:
First Name:TAMELA
Middle Name:LASHAUN
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 1:28 CHASE ST # A
Mailing Address - Street 2:
Mailing Address - City:BYHALIA
Mailing Address - State:MS
Mailing Address - Zip Code:38611-7363
Mailing Address - Country:US
Mailing Address - Phone:662-850-0365
Mailing Address - Fax:
Practice Address - Street 1:28 CHASE ST # A
Practice Address - Street 2:
Practice Address - City:BYHALIA
Practice Address - State:MS
Practice Address - Zip Code:38611-7363
Practice Address - Country:US
Practice Address - Phone:662-850-0365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
343900000XOtherNON EMERGENCY TRANSPORTATION DRIVER