Provider Demographics
NPI:1376832493
Name:JONESSMITH, MARTINA LAVERNE (CPPD)
Entity Type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:LAVERNE
Last Name:JONESSMITH
Suffix:
Gender:F
Credentials:CPPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 DARTON DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1162
Mailing Address - Country:US
Mailing Address - Phone:804-873-5636
Mailing Address - Fax:
Practice Address - Street 1:2705 DARTON DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1162
Practice Address - Country:US
Practice Address - Phone:804-873-5636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA374J00000X374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula