Provider Demographics
NPI:1710628938
Name:JONES, NATASHA NICOLE (RN)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:NICOLE
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 THORNTON WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-2635
Mailing Address - Country:US
Mailing Address - Phone:470-243-1357
Mailing Address - Fax:470-866-4688
Practice Address - Street 1:675 THORNTON WAY
Practice Address - Street 2:SUITE A
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-2635
Practice Address - Country:US
Practice Address - Phone:470-243-1357
Practice Address - Fax:470-866-4688
Is Sole Proprietor?:No
Enumeration Date:2022-04-03
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC320220163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse