Provider Demographics
NPI:1508604117
Name:JONES, LATASHA N (CNA,CMT,PHAR TECH)
Entity type:Individual
Prefix:MS
First Name:LATASHA
Middle Name:N
Last Name:JONES
Suffix:
Gender:F
Credentials:CNA,CMT,PHAR TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3699 WHISPERING WOODS DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-1155
Mailing Address - Country:US
Mailing Address - Phone:314-319-4222
Mailing Address - Fax:
Practice Address - Street 1:3699 WHISPERING WOODS DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-1155
Practice Address - Country:US
Practice Address - Phone:314-319-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCDL172A00000X
MO2005039654183700000X
MO135924251E00000X, 253Z00000X, 372500000X, 372600000X, 374U00000X, 376J00000X
MO104149251J00000X, 3747A0650X, 376K00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No172A00000XOther Service ProvidersDriver
No183700000XPharmacy Service ProvidersPharmacy Technician
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide