Provider Demographics
NPI:1427722644
Name:JONES, SHANIKA L (LPN)
Entity type:Individual
Prefix:
First Name:SHANIKA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6706 BORDEAUX BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-1826
Mailing Address - Country:US
Mailing Address - Phone:863-236-8515
Mailing Address - Fax:
Practice Address - Street 1:6706 BORDEAUX BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33811-1826
Practice Address - Country:US
Practice Address - Phone:863-236-8515
Practice Address - Fax:863-644-1139
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5203321164W00000X
171W00000X, 251E00000X, 251J00000X, 347C00000X, 372600000X, 374U00000X, 376J00000X, 376K00000X, 385H00000X
FL10D2245675247ZC0005X
FL253Z00000X, 3747P1801X, 385HR2065X
FLPN5203321164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No171W00000XOther Service ProvidersContractor
No247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
No385H00000XRespite Care FacilityRespite Care
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child