Provider Demographics
NPI:1336954619
Name:JONES, JOSHUA ELIJAH
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ELIJAH
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2527 BLONDO ST # NE68111
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-4311
Mailing Address - Country:US
Mailing Address - Phone:402-708-2146
Mailing Address - Fax:
Practice Address - Street 1:2527 BLONDO ST # NE68111
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-4311
Practice Address - Country:US
Practice Address - Phone:402-708-2146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEH13095315372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty