Provider Demographics
NPI:1528388386
Name:JONES, DONNETTA LOUISE
Entity Type:Individual
Prefix:MRS
First Name:DONNETTA
Middle Name:LOUISE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 BEECH AVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-1316
Mailing Address - Country:US
Mailing Address - Phone:219-789-0207
Mailing Address - Fax:
Practice Address - Street 1:8033 BEECH AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1316
Practice Address - Country:US
Practice Address - Phone:219-789-0207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041252828163W00000X
IN28172973A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse