Provider Demographics
NPI:1578342663
Name:JONES, AUTUMN DENAI (CNA)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:DENAI
Last Name:JONES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CALIBRE LAKE PKWY SE # 1308
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-7222
Mailing Address - Country:US
Mailing Address - Phone:463-207-2401
Mailing Address - Fax:
Practice Address - Street 1:100 CALIBRE LAKE PKWY SE # 1308
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-7222
Practice Address - Country:US
Practice Address - Phone:463-207-2401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030087216376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide