Provider Demographics
NPI:1396492591
Name:JONES, KEIARRA SANAE (CNA)
Entity type:Individual
Prefix:
First Name:KEIARRA
Middle Name:SANAE
Last Name:JONES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 GUSTINE LN APT 2809
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-1605
Mailing Address - Country:US
Mailing Address - Phone:832-571-5843
Mailing Address - Fax:
Practice Address - Street 1:2413 HOLMAN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-4245
Practice Address - Country:US
Practice Address - Phone:832-571-5843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA0060034871374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide