Provider Demographics
NPI:1851981062
Name:EDWARDS-JONES, LATONYA NICOLE
Entity Type:Individual
Prefix:
First Name:LATONYA
Middle Name:NICOLE
Last Name:EDWARDS-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 1:25382 MACOMB ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4424
Mailing Address - Country:US
Mailing Address - Phone:586-222-4319
Mailing Address - Fax:
Practice Address - Street 1:25382 MACOMB ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4424
Practice Address - Country:US
Practice Address - Phone:586-222-4319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)