Provider Demographics
NPI:1790455467
Name:LOTT JONES, STEPHENY NATASHA MEYOKEE
Entity Type:Individual
Prefix:MS
First Name:STEPHENY
Middle Name:NATASHA MEYOKEE
Last Name:LOTT 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 1:316 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OCILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31774-1439
Mailing Address - Country:US
Mailing Address - Phone:229-272-6256
Mailing Address - Fax:
Practice Address - Street 1:316 W 7TH ST
Practice Address - Street 2:
Practice Address - City:OCILLA
Practice Address - State:GA
Practice Address - Zip Code:31774-1439
Practice Address - Country:US
Practice Address - Phone:229-272-6256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor