Provider Demographics
NPI:1306102587
Name:ARMSTEAD, VONDA SHANELLE (CNA/HHA)
Entity type:Individual
Prefix:MRS
First Name:VONDA
Middle Name:SHANELLE
Last Name:ARMSTEAD
Suffix:
Gender:F
Credentials:CNA/HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 W 26TH ST.
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-9998
Mailing Address - Country:US
Mailing Address - Phone:904-438-1204
Mailing Address - Fax:
Practice Address - Street 1:1743 W 26TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-9998
Practice Address - Country:US
Practice Address - Phone:904-438-1204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA251825372600000X, 374U00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide