Provider Demographics
NPI:1851847586
Name:JONES, TIFFANY LASHEA
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LASHEA
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 1:6000 POPLAR AVENUE
Mailing Address - Street 2:STE 250
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119
Mailing Address - Country:US
Mailing Address - Phone:901-530-9755
Mailing Address - Fax:
Practice Address - Street 1:6000 POPLAR AVENUE
Practice Address - Street 2:STE 250
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119
Practice Address - Country:US
Practice Address - Phone:901-530-9755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2023-11-29
Deactivation Date:2023-05-30
Deactivation Code:
Reactivation Date:2023-11-28
Provider Licenses
StateLicense IDTaxonomies
MS1097884372600000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion