Provider Demographics
NPI:1376223487
Name:JONES, KERANISHA (CBD, CPD)
Entity Type:Individual
Prefix:
First Name:KERANISHA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CBD, CPD
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:
Other - Last Name:JONES-CLINTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CBD, CPD
Mailing Address - Street 1:2473 S HIGLEY RD STE 104-160
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1106
Mailing Address - Country:US
Mailing Address - Phone:855-779-0463
Mailing Address - Fax:
Practice Address - Street 1:2473 S HIGLEY RD STE 104-160
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1106
Practice Address - Country:US
Practice Address - Phone:855-779-0463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker