Provider Demographics
NPI:1477053148
Name:LOGSDON, JONI KAY (LVN)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:KAY
Last Name:LOGSDON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1942 S SEMINOLE ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79103-5005
Mailing Address - Country:US
Mailing Address - Phone:806-673-1704
Mailing Address - Fax:
Practice Address - Street 1:1942 S SEMINOLE ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79103-5005
Practice Address - Country:US
Practice Address - Phone:806-673-1704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX137514164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse