Provider Demographics
NPI:1699041301
Name:JONES, NEKISHA MAIRE
Entity Type:Individual
Prefix:MRS
First Name:NEKISHA
Middle Name:MAIRE
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 1:3410 KIPLING DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7315
Mailing Address - Country:US
Mailing Address - Phone:409-225-7782
Mailing Address - Fax:
Practice Address - Street 1:3410 KIPLING DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7315
Practice Address - Country:US
Practice Address - Phone:409-225-7782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32046421577OtherHEALTH CARE SERVICES