Provider Demographics
NPI:1619547106
Name:JONES, KYERA
Entity Type:Individual
Prefix:
First Name:KYERA
Middle Name:
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:PO BOX 80240
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-0240
Mailing Address - Country:US
Mailing Address - Phone:419-215-1740
Mailing Address - Fax:
Practice Address - Street 1:3648 DIXIE DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43611-1743
Practice Address - Country:US
Practice Address - Phone:419-215-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No156F00000XEye and Vision Services ProvidersTechnician/Technologist