Provider Demographics
NPI:1396504742
Name:JONA, NIKITHA
Entity type:Individual
Prefix:
First Name:NIKITHA
Middle Name:
Last Name:JONA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NIKI
Other - Middle Name:
Other - Last Name:JONA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:475 VINE ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-4135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:475 VINE ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-4135
Practice Address - Country:US
Practice Address - Phone:843-260-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program