Provider Demographics
NPI:1952035347
Name:JONES, SACARA (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:SACARA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 W TRINITY PL APT 2614
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3681
Mailing Address - Country:US
Mailing Address - Phone:510-414-3438
Mailing Address - Fax:
Practice Address - Street 1:122 WEST TRINITY PLACE
Practice Address - Street 2:STE 2614
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3681
Practice Address - Country:US
Practice Address - Phone:510-414-3438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA269124163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse