Provider Demographics
NPI:1770265449
Name:JONES, EVETTE SHARON
Entity type:Individual
Prefix:
First Name:EVETTE
Middle Name:SHARON
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EVETTE
Other - Middle Name:SHARON
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23074 UPLAND DR
Mailing Address - Street 2:
Mailing Address - City:BUSHWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20618-2128
Mailing Address - Country:US
Mailing Address - Phone:240-256-5347
Mailing Address - Fax:
Practice Address - Street 1:23074 UPLAND DR
Practice Address - Street 2:
Practice Address - City:BUSHWOOD
Practice Address - State:MD
Practice Address - Zip Code:20618-2128
Practice Address - Country:US
Practice Address - Phone:240-256-5347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD55396164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse