Provider Demographics
NPI:1790548832
Name:JONES, SHADONNA LYNN (BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:SHADONNA
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:SHADONNA
Other - Middle Name:LYNN
Other - Last Name:COLEMAN-CARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BIRTH DOULA
Mailing Address - Street 1:9335 RUSSELL CIR S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-2467
Mailing Address - Country:US
Mailing Address - Phone:612-388-7558
Mailing Address - Fax:
Practice Address - Street 1:9335 RUSSELL CIR S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-2467
Practice Address - Country:US
Practice Address - Phone:612-517-7005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula