Provider Demographics
NPI:1376280644
Name:JONES, LATOYA LAVETTE (LNA)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:LAVETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:LNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 E DUNLAP AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-3196
Mailing Address - Country:US
Mailing Address - Phone:602-488-9148
Mailing Address - Fax:
Practice Address - Street 1:1160 E DUNLAP AVE APT 2
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-3196
Practice Address - Country:US
Practice Address - Phone:602-488-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ230026376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide