Provider Demographics
NPI:1588235923
Name:JONES, DESTINY NEVAEH
Entity Type:Individual
Prefix:
First Name:DESTINY
Middle Name:NEVAEH
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 1:5728 CADDOAN RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6232
Mailing Address - Country:US
Mailing Address - Phone:757-592-8823
Mailing Address - Fax:
Practice Address - Street 1:5795 PRINCESS ANNE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3224
Practice Address - Country:US
Practice Address - Phone:757-490-0307
Practice Address - Fax:757-499-8728
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician