Provider Demographics
NPI:1629293550
Name:DAVIS, JONELLE AVRIL (RRT, RPSGT)
Entity Type:Individual
Prefix:MS
First Name:JONELLE
Middle Name:AVRIL
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RRT, RPSGT
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 8269
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-1269
Mailing Address - Country:US
Mailing Address - Phone:340-344-3440
Mailing Address - Fax:340-774-3804
Practice Address - Street 1:9150 ESTATE THOMAS
Practice Address - Street 2:SUITE 306
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2611
Practice Address - Country:US
Practice Address - Phone:340-344-3440
Practice Address - Fax:340-774-3804
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI305079-305054171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor