Provider Demographics
NPI:1902412638
Name:JONES, SHANTEL LEIGH (HOME HEALTH)
Entity Type:Individual
Prefix:
First Name:SHANTEL
Middle Name:LEIGH
Last Name:JONES
Suffix:
Gender:F
Credentials:HOME HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2256 SPURR RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-9124
Mailing Address - Country:US
Mailing Address - Phone:859-285-2004
Mailing Address - Fax:
Practice Address - Street 1:2256 SPURR RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-9124
Practice Address - Country:US
Practice Address - Phone:859-285-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPSA500309385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care