Provider Demographics
NPI:1598548844
Name:GOLSTON, JENNIFER (CNA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GOLSTON
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 1:38927 CARR DR
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33540-1837
Mailing Address - Country:US
Mailing Address - Phone:813-518-5080
Mailing Address - Fax:
Practice Address - Street 1:38927 CARR DR
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33540-1837
Practice Address - Country:US
Practice Address - Phone:813-518-5080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL399191251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health