Provider Demographics
NPI:1952134769
Name:JONES, TIFFANY LYNETTE
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LYNETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18500 STANSBURY ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-2584
Mailing Address - Country:US
Mailing Address - Phone:313-463-9894
Mailing Address - Fax:
Practice Address - Street 1:18500 STANSBURY ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2584
Practice Address - Country:US
Practice Address - Phone:313-463-9894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide