Provider Demographics
NPI:1073981288
Name:JONES, KEIRA MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:KEIRA
Middle Name:MICHELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26278 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-1335
Mailing Address - Country:US
Mailing Address - Phone:313-300-7190
Mailing Address - Fax:
Practice Address - Street 1:26278 SOMERSET DR
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-1335
Practice Address - Country:US
Practice Address - Phone:313-300-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704240978163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis