Provider Demographics
NPI:1326665704
Name:SHANK JONES, JENNIFER LYNN (RN-LACTATION CONSULT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:SHANK JONES
Suffix:
Gender:F
Credentials:RN-LACTATION CONSULT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:SHANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6925 TYBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-7201
Mailing Address - Country:US
Mailing Address - Phone:770-265-6028
Mailing Address - Fax:
Practice Address - Street 1:6925 TYBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-7201
Practice Address - Country:US
Practice Address - Phone:770-265-6028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN115604163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant