Provider Demographics
NPI:1386251791
Name:JONES, DANIESHA N
Entity type:Individual
Prefix:
First Name:DANIESHA
Middle Name:N
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 1:2993 NW 36TH LN
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33311-8355
Mailing Address - Country:US
Mailing Address - Phone:757-215-5966
Mailing Address - Fax:
Practice Address - Street 1:2993 NW 36TH LN
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33311-8355
Practice Address - Country:US
Practice Address - Phone:757-215-5966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health