Provider Demographics
NPI:1528551249
Name:JONES, LAKEISHA S
Entity Type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:S
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 1:4510 GRANADA BLVD APT 6
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-4893
Mailing Address - Country:US
Mailing Address - Phone:216-278-2160
Mailing Address - Fax:
Practice Address - Street 1:4510 GRANADA BLVD APT 6
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-4893
Practice Address - Country:US
Practice Address - Phone:216-278-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH372500000X, 251J00000X, 372600000X
OH401224230411376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No372500000XNursing Service Related ProvidersChore Provider
No251J00000XAgenciesNursing Care
No372600000XNursing Service Related ProvidersAdult Companion