Provider Demographics
NPI:1316602535
Name:JONES, VONANIQUIA TEIARA
Entity Type:Individual
Prefix:
First Name:VONANIQUIA
Middle Name:TEIARA
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 1:4611 GOVERNORS HOUSE DR SW APT 917
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-3250
Mailing Address - Country:US
Mailing Address - Phone:256-427-8942
Mailing Address - Fax:
Practice Address - Street 1:200 WESTSIDE SQ STE 605
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5064
Practice Address - Country:US
Practice Address - Phone:256-803-1661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care