Provider Demographics
NPI:1831425313
Name:JONES, MARKISHA A
Entity type:Individual
Prefix:MISS
First Name:MARKISHA
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARKISHA
Other - Middle Name:A
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:8125 N 107TH ST UNIT J
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-2500
Mailing Address - Country:US
Mailing Address - Phone:414-241-3365
Mailing Address - Fax:
Practice Address - Street 1:8125 N 107TH ST UNIT J
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-2500
Practice Address - Country:US
Practice Address - Phone:414-241-3365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI307196-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse