Provider Demographics
NPI:1134954100
Name:JONES, DONIQUE (BSN, RN, CLC)
Entity type:Individual
Prefix:MRS
First Name:DONIQUE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:BSN, RN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6271 SAINT AUGUSTINE RD STE 24-1011
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6271 SAINT AUGUSTINE RD STE 24-1011
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2523
Practice Address - Country:US
Practice Address - Phone:904-855-5647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
359312174400000X
FLRN9468706163W00000X, 163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174400000XOther Service ProvidersSpecialist
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant