Provider Demographics
NPI:1831761378
Name:JONES, FONETTA KAY (DSP)
Entity type:Individual
Prefix:MISS
First Name:FONETTA
Middle Name:KAY
Last Name:JONES
Suffix:
Gender:F
Credentials:DSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1382 COLORADO DR APT 4
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-4937
Mailing Address - Country:US
Mailing Address - Phone:937-287-1659
Mailing Address - Fax:
Practice Address - Street 1:1382 COLORADO DR APT 4
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-4937
Practice Address - Country:US
Practice Address - Phone:937-287-1659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health